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目的观察中厚皮供区应用刃厚皮回植促进创面愈合减少瘢痕的作用。方法对2002—2010年收治的192例患者行背部或大腿外侧取中厚皮,将供皮区创面分为3组,治疗组(A组)即大张及邮票刃厚皮回植覆盖,对照组功能性敷料覆盖(B组)和凡士林纱布覆盖(C组),刃厚皮供区又分为头部、大腿和后背3个部位。分别观察治疗组和对照组供皮区创面的愈合时间、局部疼痛、瘢痕生长情况。结果创面愈合的平均时间,A组为6.2±1.1 d,B组为11.1±2.1 d,C组为13.5±2.5 d;术后第2天和第5天疼痛评分,A组平均疼痛评分为2.3±0.86和1.9±0.8,B组为2.5±1.1和3.9±1.3,C组为3.8±1.4和5.9±2.1;术后6~12个月瘢痕评分,A组评分为2.8±1.5,B组为6.6±2.1,C组为8.2±3.6,3组比较差异有统计学意义(P<0.01)。刃厚皮供区头部愈合时间、疼痛评分和瘢痕生长优于后背和大腿(P<0.01)。结论刃厚皮回植能显著缩短中厚皮供区创面愈合时间,减轻患者治疗期间中厚皮供区疼痛,预防中厚皮供区瘢痕增生。
Objective To observe the effect of applying thick-skinned skin graft to promote wound healing and reduce scar in mesothelium donor area. Methods A total of 192 patients who were treated in 2002-2010 were treated with thick skin on the back or the thigh. The wounds were divided into three groups. The treatment group (group A) Group of functional dressing covering (B group) and Vaseline gauze covering (C group), blade thick skin for the area is divided into the head, thigh and back three parts. The healing time, local pain and scar growth were observed in the donor area and the control group respectively. Results The mean wound healing time was 6.2 ± 1.1 days in group A, 11.1 ± 2.1 days in group B and 13.5 ± 2.5 days in group C, respectively. The pain scores on day 2 and day 5 in group A were 2.3 ± 0.86 and 1.9 ± 0.8 in group B, 2.5 ± 1.1 and 3.9 ± 1.3 in group B, and 3.8 ± 1.4 and 5.9 ± 2.1 in group C, respectively. The scores of scars at 6 to 12 months after operation were 2.8 ± 1.5 in group A, 6.6 ± 2.1 in group C and 8.2 ± 3.6 in group C, and the difference was statistically significant (P <0.01). The healing time, pain score and scar growth were superior to those of the dorsal and thigh (P <0.01). Conclusion Replantation of thick-skinned skin can significantly shorten the wound healing time in the middle-thick-skinned donor area, reduce the pain in the middle-thick-skin donor area during the treatment and prevent the scarring in the middle-thickening donor area.