RESUMO
Objective:To study the clinical value of artificial dermis combined with autologous thin skin graft in the repair of burn scar contracture in joints.Methods:A total of 52 patients with burn scar contractures were enrolled in the No.5 Hospital of Baoding from July 2015 to April 2018. According to different methods of repair, 26 cases were used in each group. The observation group was treated with artificial dermis combined with autologous thin skin graft. The control group was treated with medium-thickness skin grafting. The survival rate of autologous skin was compared between the two groups. The tissue of artificial dermal polyester fiber was taken and HE staining was performed to observe the pathological changes. The Vancouver skin scar assessment score (VSS), functional activity, infection rate, wound healing time, and VSS score after healing of the donor site were compared between the two groups.Results:The survival rate of autologous skin in the observation group (92.31%) was not significantly different from that in the control group (84.62%) ( P>0.05). Compared with preoperative, the VSS scores at 3, 6 months and 1 year after operation in both groups were decreased ( P<0.05). The VSS scores of the observation group were lower than those of the control group at 3, 6 months and 1 year ( P<0.05). The excellent rate of functional activity in the observation group (100.00%) was higher than that of the control group (76.92%) ( P<0.05); There was no significant difference in the infection rate (3.85% vs 7.69%) and healing time of skin grafting area between the two groups ( P>0.05). The healing time of donor site was shorter than that of the control group ( P<0.05). The VSS score of the donor site was lower than that of the control group ( P<0.05). Conclusions:Artificial dermis combined with autologous thin skin graft can be used in patients with burn scar contracture in joints, which can improve the scarring of skin grafting area and donor site, shorten the healing time of donor site and improve the function of burn scar contracture joint.
RESUMO
Objective:To explore the effect of artificial dermis combined with autogenous thin skin graft on the survival rate of compound skin graft and the scar state of joints in burn patients.Methods:94 burned patients treated in Baoding Fifth Hospital from August 2017 to August 2019 were prospectively selected as the research objects. They were randomly divided into two groups with 47 cases in each group. The control group was treated with simple medium thick skin transplantation, and the observation group was treated with artificial dermis combined with autologous thin skin grafting. The recovery of the two groups (healing time of skin donor area, healing time of skin graft area, healing time under scab of burn area and hospitalization time) were compared. The survival rate of composite skin transplantation, wound healing, Vancouver Scar Scale (VSS) score, joint range of motion (shoulder abduction, knee flexion, knee extension), Burn Specific Health Scale-Brief (BSHS-B), Profile of Mood States-Short Form (POMS-SF) score and complications were compared.Results:The healing time of donor area, skin graft area, subeschar healing time and hospital stay in the observation group were shorter than those in the control group ( P<0.05). The wound healing in the observation group was better than that in the control group, and the survival rate of composite skin transplantation was higher than that in the control group ( P<0.05). After treatment, the scar state of the joint in the two groups was improved compared with that before treatment ( P<0.05); The scar thickness, vascular distribution score and total score of VSS in the observation group were lower than those in the control group ( P<0.05). After treatment, the joint range of motion in the two groups was improved compared with that before treatment ( P<0.05); The shoulder abduction, knee flexion and knee extension in the observation group were higher than those in the control group ( P<0.05). After treatment, the quality of life and psychological status of the two groups were improved compared with those before treatment ( P<0.05); The BSHS-B score of the observation group was higher than that of the control group, and the POMS-SF score was lower than that of the control group ( P<0.05); The incidence of complications in the observation group (4.26%) was lower than that in the control group (21.28%) ( P<0.05). Conclusions:Artificial dermis combined with autologous thin skin graft can significantly improve the survival rate of compound skin graft in burned patients, and can further reduce the scar condition of the joints of patients, reduce the incidence of complications, and effectively improve the prognosis of patients.