脱抗原猪腹膜作为自体微粒皮移植载体在大面积深度烧伤患者中的应用

潘博涵; 孙瑜; 汤焘; 相阳; 朱世辉

doi:10.3760/cma.j.cn501120-20190725-00311

脱抗原猪腹膜作为自体微粒皮移植载体在大面积深度烧伤患者中的应用

doi: 10.3760/cma.j.cn501120-20190725-00311

1. 海军军医大学附属长海医院烧伤外科,全军烧伤研究所,上海 200433;
2. 海军军医大学卫勤系,上海 200433

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出版历程
- 收稿日期: 2019-07-25
- 网络出版日期: 2021-10-28
- 刊出日期: 2020-09-20

Application of antigen-free porcine peritoneum as carrier of autologous microskin grafting in patients with extensive burn

1. Burn Institute of PLA, Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China;
2. Department of Health Service, Naval Medical University, Shanghai 200433, China

摘要

摘要: 目的探讨脱抗原猪腹膜替代异体皮作为载体的自体微粒皮移植治疗大面积深度烧伤患者的效果。方法回顾性分析海军军医大学附属长海医院2014年1月—2017年12月收治的32例符合入选标准的大面积深度烧伤患者的临床资料。将20例移植以异体皮为载体的微粒皮患者纳入异体皮组[男12例、女8例，年龄(35.4±2.2)岁]，将12例移植以脱抗原猪腹膜为载体的微粒皮患者纳入脱抗原猪腹膜组[男6例、女6例，年龄(32.1±4.8)岁]。伤后3～7 d，患者生命体征平稳，进行切痂、头部自体微粒皮移植术。记录2组患者微粒皮扩展比、白蛋白应用时间、抗生素应用时间、植皮区感染面积百分比、微粒皮成活率及换药次数。对数据行t检验。结果脱抗原猪腹膜组患者微粒皮扩展比为14.8±0.6，与异体皮组的13.5±0.6相近(t＝1.531，P>0.05)。2组患者白蛋白应用时间、抗生素应用时间相近(t＝0.027、1.121，P>0.05)。脱抗原猪腹膜组患者植皮区感染面积百分比[(8.5±1.2)%]明显低于异体皮组[(18.1±0.6)%，t＝7.593, P<0.01]，微粒皮成活率[(82.5±1.1)%]明显高于异体皮组[(72.5±0.6)%，t＝8.689, P<0.01]，换药次数明显少于异体皮组(t＝4.743，P<0.01)。结论与异体皮相比，脱抗原猪腹膜为载体的微粒皮移植可减少创面感染面积，提高微粒皮成活率，减少换药次数，是一种较佳的微粒皮载体。
- 烧伤 /
- 皮肤移植 /
- 微粒皮载体
Abstract: Objective To investigate the effects of microskin transplantation with antigen-free porcine peritoneum (AFPP) as substitutive carrier for allogeneic skin graft in treating patients with extensive deep burns. Methods Medical records of 32 patients with extensive deep burns, hospitalized in Changhai Hospital of Naval Medical University meeting the inclusion criteria were investigated from January 2014 to December 2017. Twenty patients [12 males and 8 females, aged (35.4±2.2) years]with microskin transplantation using allogeneic skin graft as microskin carrier were included in allogeneic skin graft group and 12 patients [6 males and 6 females, aged (32.1±4.8) years] with microskin transplantation using AFPP as microskin carrier were included in AFPP group. On post injury day 3-7, the vital signs of patients were stable and escharectomy and autologous microskin grafting of head were performed. The expansion ratio of microskin, the application time of albumin and antibiotics, the percentage of infectious autologous microskin grafting area, the survival rate of microskin, and dressing change times of patients in 2 groups were recorded. Data were statistically analyzed with t test. Results The expansion ratio of microskin of patient in AFPP group was 14.8±0.6, which was close to 13.5±0.6 of allogeneic skin graft group (t=1.531, P>0.05). The application time of albumin and antibiotics of patients in AFPP group were close to those of allogeneic skin graft group (t=0.027, 1.121, P>0.05). The percentage of infectious autologous microskin grafting area of patients in AFPP group was (8.5±1.2)%, which was significantly lower than (18.1±0.6)% in allogeneic skin graft group in 4 weeks after surgery(t=7.593, P<0.01), the survival rate of microskin of patients in AFPP group was (82.5±1.1)%, which was significantly higher than (72.5±0.6)% in allogeneic skin graft group (t=8.689, P<0.01). The dressing change time of patients in AFPP group was significantly less than that in allogeneic skin graft group (t=4.743, P<0.01). Conclusions Compared with allogeneic skin graft, microskin transplantation with AFPP as carrier can reduce wound infection, improve the survival rate of microskin graft, and reduce dressing change time, so that AFPP is a good carrier of microskin.
- Burns /
- Skin transplantation /
- Microskin carrier