皮肤缺损.doc

38例先天性皮肤缺损创面不同治疗方法的疗效分析
刘燕, 邱林,傅跃先,田晓菲,肖军,袁心刚,李天武(400014重庆,重庆医科大学附属儿童医院烧伤整形科)
[摘要] 目的探讨先天性皮肤缺损的创面处理方法。方法 38例先天性皮肤缺损创面,18例10%以下创面保守治疗(其中13例去膜,5例膜全)、1例7%的创面保守+大张刃厚植皮治疗、16例10%以上创面大张刃厚植皮治疗、3例伴骨缺损创面人工真皮+大张刃厚植皮治疗,总结不同面积、缺损深度创面不同处理方法的长期随访结果。结果本组38例均恢复良好。7例出院后失访。31例随访5个月至7年不等。14例(包括部分保守、部分手术病例)保守治疗创面, 5例未去膜创面愈合较去膜创面快,且3例愈合后仅遗留色素减褪,2例遗留平、软、色素减褪浅表瘢痕,去膜的9例创面愈合后均遗留轻重不等瘢痕伴色素减褪。15例(包括部分保守、部分手术病例)刃厚植皮治疗创面愈合后5例无明显瘢痕,5例遗留平、软羊皮纸样瘢痕,5例遗留轻重不等增生性瘢痕;3例人工真皮+刃厚植皮的头皮缺损+颅骨缺损创面均遗留平、软、与皮肤同色瘢痕伴秃发,其深部颅骨缺损均已痊愈。结论先天性皮肤缺损创面覆盖膜为发育不良表皮,有促进创面愈合作用;10%以下创面保守治疗能达到理想创面愈合效果,但处理中需完整保留其表面覆盖的膜;10%以上创面由于愈合时间较长为避免并发症发生建议大张刃厚植皮封闭;伴颅骨缺损创面不需处理骨缺损。
[关键词] 先天性皮肤缺损;创面;长期随访:疗效
[中图法分类号] [文献标志码] A
Curative effect analysis of different treatment methods to 38 cases Congenital Skin Defect wounds
Liu Yan,Qiu Lin,Fu Yuexian,Tian Xiaofei,Xiao Jun,Yuan Xingang,Li Tianwu.(Department of Burn and Plastic,Chongqing Children ’s Hospital Affiliated to Chongqing Medical University,Chongqing 400014,China)
[Abstract] Objective To explore the treatment methods to the wounds of Congenital Skin In 38 cases of Congenital Skin Defect, 18 cases’ wounds of less than 10% were bandaged and dressing changed(13 of them were removaled membrane ,5 of them were remained membrane),1 cases’ wounds of 7% were bandaged and dressing changed and grafted of big piece razor thin autoskin,16 cases’ wounds of more than 10% were grafted of big