新技术与临床
ENGLISH ABSTRACT
深度烧伤创面削痂后植皮结合自体细胞再生技术治疗的临床研究
胡志成
张逸
唐冰
王鹏
黄韶斌
董云先
徐海琳
温日妮
荣燕超
朱家源
作者及单位信息
·
DOI: 10.3760/cma.j.cn115668-20201104-00302
Skin grafting aided with autologous cell regeneration technique in managment of deep burn wounds following tangential excision: a clinical study
Hu Zhicheng
Zhang Yi
Tang Bing
Wang Peng
Huang Shaobin
Dong Yunxian
Xu Hailin
Wen Rini
Rong Yanchao
Zhu Jiayuan
Authors Info & Affiliations
Hu Zhicheng
Department of Burn Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
Zhang Yi
Department of Burns and Plastic Surgery, Nantong University Hospital, Nantong 226001, Jiangsu, China
Tang Bing
Department of Burn Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
Wang Peng
Department of Burn Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
Huang Shaobin
Department of Burn Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
Dong Yunxian
Department of Burn Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
Xu Hailin
Department of Burn Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
Wen Rini
Department of Burn Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
Rong Yanchao
Department of Burn Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
Zhu Jiayuan
Department of Burn Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
·
DOI: 10.3760/cma.j.cn115668-20201104-00302
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摘要

目的观察自体细胞再生技术治疗深度烧伤削痂后植皮的效果。

方法分析2014年3月至2018年3月我科住院的深度烧伤患者54例,其中27例患者术中应用自体细胞再生技术(细胞分选仪,广州市麦施缔医疗科技有限公司,粤穗械备:20201238号)结合游离皮片移植,27例患者常规使用游离皮片移植修复创面。于术后对比两组创面的愈合时间和愈合效果。

结果应用自体细胞再生技术结合植皮后,与对照组相比,实验组愈合时间更短愈合后远期效果更佳,两组差异有统计学意义(P<0.05)。在术后首次换药时疼痛程度,术后植皮并发症方面,两组之间差异无统计学意义。

结论自体细胞再生技术可有效促进烧伤创面愈合,缩短愈合时间,并且安全性高。

深度烧伤;临床研究;皮片移植
ABSTRACT

ObjectiveTo investigate the outcomes of skin grafting aided with autologous cell regeneration technique for treatment of deep burn wounds following tangential excision of eschars.

MethodsIncluded in this study were a total of 54 patients with deep burns hospitalized in our department between March 2014 and March 2018. Among them, 27 patients (study group) underwent free skin grafting aided with autologous cell regeneration technique (MYSEED ®kit) , and the other 27 (control group) received conventional free skin grafting, for wound repair. The wound healing time and healing outcome after operation were compared between the two groups.

ResultsCompared with the control group, use of autologous cell regeneration technique lead to shorter healing time and better long-term outcome after wound healing in the study group, with statistically significant difference between groups ( P<0.05) . The two groups did not differ statistically in terms of pain during the first dressing change and postoperative complications of the skin grafting.

ConclusionUse of autologous cell regeneration technique can effectively promote healing of burn wounds and shorten the healing time, with high patient safety profiles.

Deep burn;Clinical study;Skin grafting
Zhu Jiayuan, Email: nc.defudabe.usys.liamyaijuhz
引用本文

胡志成,张逸,唐冰,等. 深度烧伤创面削痂后植皮结合自体细胞再生技术治疗的临床研究[J]. 中华生物医学工程杂志,2020,26(06):536-540.

DOI:10.3760/cma.j.cn115668-20201104-00302

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评价本文
*以上评分为匿名评价
游离皮片移植技术是目前治疗深度烧伤创面的主要方法。对于Ⅲ度烧伤创面,切痂后在血运良好、界线清楚的深筋膜层植皮,皮片成活率较高。对于深Ⅱ度烧伤创面,削痂后尽量保留真皮组织,以获得良好远期修复效果。但是,对于部分Ⅲ度烧伤创面,脂肪组织并未全层受累,出于保护组织外形和良好功能的需要,需保留健康脂肪组织,在脂肪断层表面植皮。然而,脂肪组织血运较差,有可能发生感染、液化,导致植皮成活率不高 [ 1 ]。因此,如何提高深度烧伤创面削痂后移植皮片的成活率是临床中亟需解决的难题。
随着细胞分离培养、细胞喷洒技术的研究,自体细胞再生技术出现并在临床开始应用 [ 2 ]。该技术无需在体外进行细胞培养,术中即可完成,可满足1∶80(每1 cm 2皮片制备的细胞悬液可应用于80 cm 2的创面)的比例应用于自体创面 [ 3 ]。目前该技术已广泛应用于临床,包括直接应用于烧伤、创伤等急性创面 [ 3 ],瘢痕、色素性疾病修复 [ 4 ],课题组前期将该技术应用于供皮区 [ 5 ],慢性创面 [ 6 ]等,取得了良好的效果。如果将自体细胞再生技术结合自体皮片移植应用于深度烧伤创面,有望可以进一步提高植皮成活率,促进创面愈合。
为了解自体细胞再生技术结合自体皮片移植在深度烧伤创面的临床效果,选取2014年3月至2018年3月我科住院的深度烧伤患者54例,分为实验组和对照组,其中实验组患者使用自体细胞再生技术结合自体皮片移植,与对照组单纯用自体皮片移植的患者相比,取得了良好的临床效果。
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备注信息
A
朱家源,Email: nc.defudabe.usys.liamyaijuhz
B
所有作者均声明不存在利益冲突
C
国家自然科学基金面上资助项目 (82072180,82072181,81871565)
广东省科技科技发展专项资金 (2016B090916001)
广东省基础与应用基础研究基金 (2019A1515012208)
中山大学临床医学研究5010计划项目 (2013001,2018002,2018003)
高校基本科研业务费 (19ykpy66)
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