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Dealing with the concept of plastic burn wounds


Minimum area of ​​8cm × 8cm, a maximum of 25cm × l7cm. Using allogenic acellular dermal matrix 4l cases of 58,[link widoczny dla zalogowanych], and dissimilar cases of acellular dermal matrix l2 l2 block. Adopt one-step transplantation, 70 of 63 to 100% survival,[link widoczny dla zalogowanych], the survival rate was 90%; three transplants failed due to infection in burn wounds, accounting for 0.4%; four parts survived, because opened for 5 days after is not bandaged, accounting for 5.7%. In practice, we realize that the survival of early process of composite skin and normal skin graft survival of the process is not exactly the same: ordinary skin graft and establishment of blood supply to create the base, while the composite skin graft addition to creating the base to establish blood supply, but also epidermal dermal junction area to restructure the basement membrane zone. Therefore, the first time after transplant revealed to be two weeks to continue medical education Volume 21, No. 13 on. Survival after the composite skin is soft, flexible, similar to normal skin color and texture. , 3 (3) acellular dermal matrix as a heterogeneous, early survival after transplantation is good, but after 3 months of chronic rejection, there are small pieces of local ulceration, getting even into a film, even after the planting of white body skin to heal. In short, acellular dermal matrix combined with the white body blade thickness skin graft full-thickness skin wounds in effect, it plays a permanent dermal or dermal tissue regeneration stability, has become the consensus. 4 skin source scarcity of scar contracture deformity in patients with advanced how to repair scar 4.1 expansion severe burn large areas of skin, body skin source scarcity as white, early closure of the wound with normal skin and only burn the beginning of deep Ⅱ take more area planted in the skin wound, the very thin skin graft, the more scar contracture after local deformities and serious, but the source nor the white body skin is generally believed that no further plastic surgery. We have formed part of the region with burn scar contraction expander implant the site, a place in the back of the expander 450 ~ 500ml two in the expansion is given to 40cm × l0cm or 60cm × 10cm scar skin, this skin graft purely microscopic view of scar tissue, a thin layer of epidermal cell layers is mainly of collagen fibers, fat and vascular tissue, within which there is a little inflammatory cell infiltration. The percussion section was taken taken by anti-spare in the thick scar skin. Donor site wounds of direct suture. 9 side of the 5 cases of severe deformity of axillary scar contracture, 4 side of the elbow, two cases of anterior l cases of hypertrophic scars and scar excision release claw back of the hand transplant scar thickness skin wound,[link widoczny dla zalogowanych], after l0 ~ l2 days revealed that both 100% survival of skin grafts 3 months after the soft, axillary, elbow surgery returned to normal function, such as the axilla,[link widoczny dla zalogowanych], the two upper limbs can be on the move 170. . In effect, similar in thickness skin or full thickness skin effect. 4.2 Composite skin graft expander put some patients are difficult to find the site, then use the skin and scars acellular dermal graft in the combined one-step wound after excision of scar ulcers, 5 patients have been transplanted (9 sides) on the country side of the elbow and 7 Department of scar ulcer, ulcer scar line of wide excision, the maximum area of ​​42cm × l3cm, a minimum of 30cm × l5cm, wound with 1% hydrogen peroxide solution, repeatedly washed with normal saline and metronidazole three times,[link widoczny dla zalogowanych], so to minimize bacterial limit, and then transplanted acellular dermal matrix; with an electric knife remove the scar edge to take thick skin, acellular dermis transplanted, the line of packaged dressing. L0 days after surgery revealed, see skin graft survival, re-bandaged the wound secretions after time depending on how much dressing, depending on study and outline a domestic master the vast auditorium of autologous skin grafting method. 2 master skin source scarcity of scar contracture deformity in patients with advanced how to fix. 3 familiar with the damage of the burn flap method. 4. Understanding of composite skin graft method. If a good infection control, composite skin after several i00% survival after dressing. The early part is hard, after 3 months follow-up, skin soft, local approximate thickness skin from the effects of the body, functional recovery, flexion freely. From the quality point of view, the appearance of skin scars scar than skin before transplantation better appearance and texture, and its mechanism may be playing the same kind of permanent dermal dermal dermal and guided tissue regeneration In short, with a focus on large area burns heal, the source of acute shortage of autologous skin of patients with expansion of the dilator was taking anti-scar skin scar in the thick edge of thick skin or scar the skin as a composite skin transplantation in wound, two effects are good for the treatment of these patients provides a new fix. Use of technology in today's plastic surgery wound repair, the repair can achieve more satisfactory results have broad clinical applications. CONTINUINGMEDICALEDUCATIONVb1.21. NO. 13
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