EFFECTIVENESS OF SCAR SPLIT THICKNESS SKIN GRAFT COMBINED WITH ACELLULAR ALLOGENEIC DERMIS IN TREATMENT OF LARGE DEEP Ⅱ DEGREE BURN SCAR_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CUIZelong ¹ , YANGXiaohui ¹ , SHOUJiabao ¹ ,  WANGGuangyi ²

1. Department of Burn and Plastic Surgery, the 4th Affiliated Hospital of Guangxi Medical University, Liuzhou Guangxi, 545005, P. R. China;
2. Department of Burn, Changhai Affiliated Hospital of the Second Military Medical University;

Corresponding author：

WANGGuangyi, Email: southeast000@163.com

Keywords：

Acellular allogeneic dermis; Scar spl it thickness skin; Deep Ⅱ degree burn; Scar

DOI：

10.7507/1002-1892.20140325

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Objective To investigate the feasibil ity and effectiveness of using scar spl it thickness skin grafts combined with acellular allogeneic dermis in the treatment of large deep Ⅱ degree burn scar. Methods Between January 2013 and December 2013, 20 cases of large deep Ⅱ degree burn scar undergoing plastic operation were enrolled. There were 14 males and 6 females, aged 4 to 60 years (mean, 40 years). Burn reasons included hydrothermal burns in 10 cases, flame burns in 9 cases, and lime burns in 1 case. The burn area accounted for 70% to 96% total body surface area (TBSA) with an average of 79% TBSA. The time from wound healing to scar repair was 3 months to 2 years (mean, 7 months). Based on self-control, 0.7 mm scar spl it thickness skin graft was used to repair the wound at the right side of joints after scar resection (control group, n=35), 0.5 mm scar spl it thickness skin graft combined with acellular allogeneic dermis at the left side of joints (trial group, n=30). Difference was not statistically significant in the scar sites between 2 groups (Z=-1.152, P=0.249). After grafting, negative pressure drainage was given for 10 days; plaster was used for immobilization till wound heal ing; and all patients underwent regular rehabil itation exercises. Results No significant difference was found in wound heal ing, infection, and healing time between 2 groups (P>0.05). All patients were followed up for 6 months. According to the Vancouver Scar Scale (VSS), the score was 5.23±1.41 in trial group and was 10.17±2.26 in control group, showing significant difference (t=8.925, P=0.000). Referring to Activities of Daily Living (ADL) grading standards to assess joint function, the results were excellent in 8 cases, good in 20 cases, fair in 1 case, and poor in 1 case in trial group; the results were excellent in 3 cases, good in 5 cases, fair in 22 cases, and poor in 5 cases in control group; and difference was statistically significant (Z=-4.894, P=0.000). Conclusion A combination of scar spl it thickness skin graft and acellular allogeneic dermis in the treatment of large deep Ⅱ degree burn scar is feasible and can become one of solution to the problem of skin source tension.

Citation： CUIZelong, YANGXiaohui, SHOUJiabao, WANGGuangyi. EFFECTIVENESS OF SCAR SPLIT THICKNESS SKIN GRAFT COMBINED WITH ACELLULAR ALLOGENEIC DERMIS IN TREATMENT OF LARGE DEEP Ⅱ DEGREE BURN SCAR. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(12): 1502-1504. doi: 10.7507/1002-1892.20140325 Copy

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2.	黄跃生. 烧伤外科学. 北京:科学技术文献出版社, 2010:636-644.
3.	冯祥生, 陈晓东, 谭家驹, 等. 异种(猪)脱细胞真皮基质在瘢痕整形中的应用. 中华整形外科杂志, 2007, 23(5):391-393.
4.	周庆红, 蔡兴东, 徐昕, 等. 脱细胞异体真皮在烧伤后瘢痕整形中的应用. 海军医学杂志, 2007, 28(3):204-206.
5.	季一发, 陈新龙, 侯晓华, 等. 异体真皮在大面积烧伤后期功能整形的应用. 西南军医, 2009, 11(5):820-821.
6.	徐丹, 罗成群, 陈铁夫, 等. 皮肤软组织扩张术用于烧伤晚期瘢痕整形的疗效观察. 中国医师杂志, 2007, 9(5):644-645.
7.	丁先超, 沈峻, 孙晖, 等. 人工真皮在手部瘢痕挛缩整形中的应用. 中外健康文摘, 2011, 8(48):140-141.
8.	郑捷新, 张勤, 刘琰, 等. 大面积烧伤瘢痕的后期整复治疗. 上海交通大学学报:医学版, 2010, 30(5):600-603.
9.	张文振, 章锦成, 陈如俊, 等. 反复切取后躯干瘢痕皮用于特大面积深度烧伤瘢痕整形的观察. 中华损伤与修复杂志(电子版), 2013, 8(4):384-386.
10.	刘海兵, 唐丹, 曹海燕, 等. 温哥华瘢痕量表的信度研究. 中国康复医学杂志, 2006, 21(3):240-242.
11.	潘云川, 徐家钦, 袁素, 等. 异体脱细胞真皮基质加自体刃厚皮复合移植远期随访评价. 中华烧伤杂志, 2010, 26(6):439-443.
12.	李津军. 加压疗法在预防和控制烧伤瘢痕增生与挛缩中的应用. 中国冶金工业医学杂志, 2010, 27(2):172-173.
13.	刘广毅, 杨军成. 脱细胞异体真皮基质修复口腔组织缺损的疗效观察. 四川医学, 2012, 33(7):1206-1207.
14.	王伟. 整形外科学上册. 杭州:浙江科学技术出版社, 1999:77.

1. 马文元. 实用烧伤治疗学. 郑州:郑州大学出版社, 2001:386-390.
2. 黄跃生. 烧伤外科学. 北京:科学技术文献出版社, 2010:636-644.
3. 冯祥生, 陈晓东, 谭家驹, 等. 异种(猪)脱细胞真皮基质在瘢痕整形中的应用. 中华整形外科杂志, 2007, 23(5):391-393.
4. 周庆红, 蔡兴东, 徐昕, 等. 脱细胞异体真皮在烧伤后瘢痕整形中的应用. 海军医学杂志, 2007, 28(3):204-206.
5. 季一发, 陈新龙, 侯晓华, 等. 异体真皮在大面积烧伤后期功能整形的应用. 西南军医, 2009, 11(5):820-821.
6. 徐丹, 罗成群, 陈铁夫, 等. 皮肤软组织扩张术用于烧伤晚期瘢痕整形的疗效观察. 中国医师杂志, 2007, 9(5):644-645.
7. 丁先超, 沈峻, 孙晖, 等. 人工真皮在手部瘢痕挛缩整形中的应用. 中外健康文摘, 2011, 8(48):140-141.
8. 郑捷新, 张勤, 刘琰, 等. 大面积烧伤瘢痕的后期整复治疗. 上海交通大学学报:医学版, 2010, 30(5):600-603.
9. 张文振, 章锦成, 陈如俊, 等. 反复切取后躯干瘢痕皮用于特大面积深度烧伤瘢痕整形的观察. 中华损伤与修复杂志(电子版), 2013, 8(4):384-386.
10. 刘海兵, 唐丹, 曹海燕, 等. 温哥华瘢痕量表的信度研究. 中国康复医学杂志, 2006, 21(3):240-242.
11. 潘云川, 徐家钦, 袁素, 等. 异体脱细胞真皮基质加自体刃厚皮复合移植远期随访评价. 中华烧伤杂志, 2010, 26(6):439-443.
12. 李津军. 加压疗法在预防和控制烧伤瘢痕增生与挛缩中的应用. 中国冶金工业医学杂志, 2010, 27(2):172-173.
13. 刘广毅, 杨军成. 脱细胞异体真皮基质修复口腔组织缺损的疗效观察. 四川医学, 2012, 33(7):1206-1207.
14. 王伟. 整形外科学上册. 杭州:浙江科学技术出版社, 1999:77.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF SCAR SPLIT THICKNESS SKIN GRAFT COMBINED WITH ACELLULAR ALLOGENEIC DERMIS IN TREATMENT OF LARGE DEEP Ⅱ DEGREE BURN SCAR

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