[Effects of acellular allogeneic dermis combined with autologous split-thickness skin grafts in repairing deep burn wounds in head, face, neck, and torso in children].

Abstract

Objective: To analyze the effects of acellular allogeneic dermis combined with autologous split-thickness skin grafts in repairing deep burn wounds in head, face, neck, and torso in children. Methods: This study was a historical control study. Thirty children who were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital (hereinafter referred to as our hospital) from January 2013 to May 2018 and underwent autologous split-thickness skin grafting alone for repairing deep burn wounds were selected as control group, including 15 males and 15 females, aged from 7 months to 13 years. Thirty-one children who were admitted to our hospital from June 2018 to May 2021 and underwent acellular allogeneic dermis combined with autologous split-thickness skin grafting for repairing deep burn wounds were selected as observation group, including 17 males and 14 females, aged 6 months to 13 years. The wound healing time of children in the two groups was recorded, the survival rates of skin grafts on 15 d after operation were calculated, and the incidences of adverse reactions such as pain and pruritus after wound healing were calculated. One year after operation, the Vancouver scar scale (VSS) was used to score the scars in the grafted area in the two groups of children in terms of color, thickness, softness, and vascular distribution, and the total VSS score was calculated; the satisfaction of one family member of children with the curative effect was investigated by using the efficacy satisfaction questionnaire developed by our hospital, and the satisfaction rate was calculated. Results: The wound healing time of children in control group was significantly shorter than that in observation group (t=8.86, P<0.05). There were no statistically significant differences in the survival rates of skin grafts on 15 d after operation, and the incidences of pain and pruritus after wound healing in children between the two groups (P>0.05). One year after operation, the scores of thickness, softness, color, and vascular distribution and the total score of VSS of scars in the skin grafting areas in children in observation group were 1 (0, 1), 2 (1, 2), 1 (0, 1), 1 (0, 1), and 4 (3, 5), which were significantly lower than 3 (2,4), 3 (3, 4), 2 (2, 3), 2 (2, 3), and 11 (10, 12), respectively in control group (with Z values of 6.20, 6.10, 6.42, 6.16, and 6.73, respectively, P<0.05). One year after operation, the satisfaction rate with the curative effect of one family member of children in observation group was 96.77% (30/31), which was significantly higher than 76.67% (23/30) in control group (P<0.05). Conclusions: Acellular allogeneic dermis combined with autologous split-thickness skin grafts for repairing deep burn wounds in head, face, neck, and torso in children can improve the wound healing quality, alleviate scar, and increase the satisfaction degree of children's family members. It is worthy of promotion and clinical application.