To investigate the effect of allogeneic acellular dermis on the treatment of deep burn wounds in the hand.

From May 2005 to March 2017, 62 cases (124 hands) of patients with deep burns who met the inclusion criteria in the Department of Burns and Plastic Surgery, 906th Hospital of the People′s Liberation Army Joint Service Support Unit (formerly 113 Hospital) were selected. According to the random number table method, patients were divided into a composite skin group and a simple autologous blade thick skin group, each group had 31 cases and 62 hands. The composite skin group was treated with allogeneic acellular dermal scaffold plus autologous large blade thick skin graft. The autologous blade thick skin group was transplanted with autologous blade thick skin graft. The postoperative skin survival, hand function, scar hyperplasia and appearance recovery were observed. The telephone and WeChat were followed up for 0.5 to 1.0 years. Data were compared with Fisher′s exact probability method.

In 31 patients (62 hands) of the composite skin group, the overall hand shape was flat, full, pressure-resistant and anti-friction. All of them didn′t undergo secondary scar plastic surgery. In 31 patients (62 hands) with simple autologous blade thick skin group, the overall hand appearance was poor in flatness, not fullness, poor elasticity, no pressure resistance, poor abrasion resistance and poor stretchability. In the composite skin group, 60 patients with mild hyperplasia after operation and 2 patients with severe hyperplasia; 12 patients with mild hyperplasia of scar and 50 patients with severe hyperplasia in the simple autologous blade thick skin group, the difference between the two groups was statistically significant (with P values below 0.05). In the composite skin group, the hand function recovered well in 62 hands, and the recovery was 0 hands. The hand function of the simple autologous blade thick skin group recovered well in 4 hands, and the functional recovery was poor in 58 hands. the difference between the two groups was statistically significant (with P values below 0.05). Sixteen patients (32 hands) in the simple autologous blade thick skin group underwent plastic surgery again, and 10 cases′ joint activities did not completely return to normal. In addition, 13 patients (26 hands) also had different degrees of joint movement disorder, but no plastic surgery was performed.

Allogeneic acellular dermal scaffold can effectively guarantee the appearance of skin grafting for wound repair (flatness, fullness, pressure resistance, abrasion resistance, elasticity, extensibility), and restore the function of hand movement to the maximum extent. The therapeutic effect is exact, and the donor skin area is recovered well, which has good clinical application value and is worth popularizing.

Burns; Skin transplantation; Hand; Acellular dermis