裂厚皮肤移植与临时皮肤替代物应用于手部深度真皮烧伤的治疗:疤痕弹性和灌注的回顾性队列研究。

IF 1.4 Q3 EMERGENCY MEDICINE
International Journal of Burns and Trauma Pub Date : 2021-08-15 eCollection Date: 2021-01-01
Virginia Galati, Reinhard Vonthein, Felix Stang, Peter Mailaender, Tobias Kisch
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引用次数: 0

摘要

手部深层皮肤烧伤的两种治疗选择是切向切除后自体裂厚皮肤移植(STSG)和去除烧伤水泡后应用临时伤口敷料Suprathel。我们比较了两种治疗方式在治疗完成后至少一年后烧伤疤痕的弹性和灌注。选取2013年至2018年我科80例手部深层皮肤烧伤患者,于治疗完成至少1年后的2019年进行病例系列检查,其中女性24例,男性56例,中位年龄47.6岁。采用温哥华疤痕量表(VSS)和患者与观察者疤痕评估量表(POSAS)进行疤痕的临床评估,采用吸力法(MPA 580)和双手O2C装置进行客观评估。我们的统计分析显示,两种治疗方法的R2和R5弹性值无统计学差异。STSG和suprathel治疗后烧伤疤痕的弹性、微循环灌注参数和疤痕评分与各自皮肤健康区域比值的95%置信区间大多为1。R2粘弹性亚组分析和疤痕压迫治疗、尼古丁消耗、年龄、烧伤疤痕的掌侧或背侧定位以及年龄与吸烟和定位的相互作用的调整分析得出了相似的结果。SO2校正分析显示,与Suprathel处理相比,STSG处理后SO2值降低了9%,具有统计学意义。切向切除后的裂厚皮肤移植和去除烧伤水泡后的Suprathel应用可能是治疗手部深层皮肤烧伤的等效选择。为了发现可能的微小差异,需要对更大的样本进行进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Split thickness skin graft versus application of the temporary skin substitute suprathel in the treatment of deep dermal hand burns: a retrospective cohort study of scar elasticity and perfusion.

Split thickness skin graft versus application of the temporary skin substitute suprathel in the treatment of deep dermal hand burns: a retrospective cohort study of scar elasticity and perfusion.

Split thickness skin graft versus application of the temporary skin substitute suprathel in the treatment of deep dermal hand burns: a retrospective cohort study of scar elasticity and perfusion.

Two therapeutic options for deep dermal hand burns are autologous split-thickness skin graft (STSG) following tangential excision and the application of the temporary wound dressing Suprathel following removal of burn blisters. We compared elasticity and perfusion of burn scars after both types of therapy at least one year after completion of treatment. A case series of 80 patients of our department with deep dermal hand burns between 2013 and 2018 was examined in the year 2019 at least one year after completion of treatment (24 females and 56 males with a median age of 47.6 years). The clinical assessment of the scar was performed with the Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) and the objective assessment with suction cutometry (MPA 580) and an O2C device on both hands. Our statistical analysis showed no statistically significant differences for the R2 and R5 elasticity values between the two types of therapy. The 95% confidence intervals for the ratios of elasticity, and microcirculatory perfusion parameters and scar scale scores of burn scars to respective healthy areas of skin after STSG and Suprathel-therapy mostly covered 1. Subgroup analysis of R2 viscoelasticity and analyses with adjustments for scar compression therapy, nicotine consumption, age, palmar or dorsal localization of the burn scar and interactions of age with smoking and localization gave similar results. The adjusted analysis of SO2 showed statistically significant lower SO2 values, 9% less, after STSG compared to Suprathel treatment. Split-thickness skin graft following tangential excision and the application of Suprathel following removal of burn blisters may be equivalent options for treatment of deep dermal hand burns. To detect possible small differences, further studies with larger samples are required.

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