The effect of artificial dermis combined with autogenous thin skin graft on the survival rate of compound skin grafts and the scar state of joints in burned patients / 中国医师杂志

ABSTRACT

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.