目录

摘　要：目的:通过对断层皮肤供皮区创面实行皮肤原位再生技术和凡士林纱布覆盖方法治疗的临床资料调查,分析两种处理方法的近期治疗效果,客观评价皮肤原位再生技术对刃厚、薄中厚、厚中厚皮肤供区创面的疗效,规范技术操作规程,扩大湿润烧伤膏治疗适应证.方法:供皮区常规准备,术前随机将同一创面分为MEBO治疗区和凡士林纱布治疗区,局部浸润麻醉者原则上麻醉药品内不添加肾上腺素类药物,创面压迫止血;术后即可均以相应方法处理和包扎治疗;两组创面检查与换药时间原则同步进行;主要观察指标为镇痛效果、创面愈合时间和并发症等.结果:MEBO治疗组对刃厚、薄中厚、厚中厚皮供区创面的镇痛作用均明显优于凡士林组(X2=29.380、113.344、88.128),P＜0.005;供皮区愈合时间分别为:①刃厚皮供区:MEBO组为8.69±2.75天,凡士林组为12.46±2.29天;②薄中厚皮供区:MEBO组为11.56±3.61天,凡士林组为14.39±3.38天;③厚中厚皮供区:MEBO组为15.65±2.68天,凡士林组为18.71±3.84天;积液、积血、感染等并发症主要发生在厚中厚皮供区创面,但MEBO组的发生率明显低于凡士林组,P＜0.005.结论:MEBO对断层皮供区创面有良好的镇痛作用,能促使供皮区皮肤原位再生修复,愈合时间缩短,并发症降低,MEBO是治疗断层皮供区创面的良好适应证.
关键词：断层皮肤;供区创面;皮肤原位再生;MEBO;凡士林;近期疗效
分类号：R622.1;R418;R282.71　文献标识码：A
文章编号：1001-0726(2006)01-0001-09

Clinical Study Report on Treating Split Skin Thickness Donor Site in Skin Regeneration in Situ with MEBO

Special subject study group,burns committee,China Society of Integrated Traditional Chinese and Western Medicine　

Abstract：Objective: Based on the data of multicenter clinical investigation of treating split skin thickness donor sites (SSTDS) in skin regeneration in situ technique with MEBO and in standard method- - - covering wounds with Vaseline gauze, the clinical effects in latest term (1 -3 months) of two methods are evaluated and compared in the report, i. e. Evaluate clinical effects on treating thin split thickness, thin intermediate thickness and thick intermediate thickness skin donor site in skin regeneration in situ technique with MEBO and in standardize operation procedure with Vaseline gauze was evaluated objectively, the protocol of treating SSTDS with MEBO was established and,therefore, the claimed indication of Moist Exposed Burn Ointment (MEBO) was extended. Method: Preparing the harvest of split- thickness graft at skin donor site as routine. Delimit each donor site randomly into 2 groups of sites, MEBO treating site and Vaseline treating site before the harvest. No medicine categorized as adrenalin were required to be added into local anaesthesia generally. Hemostasis at the local donor site was done by compressing on wounds. After operation, wounds of two groups were treated and wrapped with respective methods. Examining the wounds and renewing drug for the two group wounds should be conducted at the same time. The main observation indexes includes stop - pain effect, wound healing time and complication etc. Results: In MEBO group, the stop - pain effect on all 3 kinds of donor sites, i. e. thin split thickness, thin intermediate thickness and thick intermediate thickness skin donor site is superior to that in Vaseline group (X2 = 29.380,113.344, 88.128, P＜0.005. The healing time of skin donor site are listed as the follows respectively: 1. thin thickness skin donor site:MEBO group is 8.69±2.75 days, Vaseline group is 12.46±2.29 days; 2. thin intermediate thickness skin donor site: MEBO group is 11.56±3.61 days, Vaseline group is 14.39±3.38 days; 3. thick intermediate thickness skin donor site: MEBO group is 15.65±2.68days, Vaseline group is 18.71±3.84 days. The complications such as hydrops, hematocele and infection etc mainly appear on thick intermediate thickness skin donor site, but the incidence rate is obviously lower in MEBO group, P＜0.005. Conclusion: MEBO has an stop- pain effect on skin donor site, promotes skin donor site regenerate in situ, shortens healing time and decreases complications. Skin donor site should be the indication of MEBO.
Keywords：Split skin; skin donor site; skin regeneration in situ; MEBO; Vaseline; latest clinical effects.

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