论文部分内容阅读
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,总结不同缺损程度及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。
Objective To investigate the method of treating wounds with congenital skin defects. Methods Thirty-eight patients with congenital skin defect and 18 patients with less than 10% wounds were treated conservatively (13 of them were treated with membrane and 5 patients with complete membrane). One patient was treated with 7% 3 cases of artificial dermis + large blade thick skin grafting with bone defect were treated, and different long-term follow-up results of different defect degree and different treatment methods were summarized. Results The group of 38 patients recovered well. Seven patients were lost to hospital after discharge. 31 cases were followed up for 5 months to 7 years. Of the 14 cases (including some conservative cases and some cases of surgery), 5 cases of non-membrane wound healing was faster than those of the wound membrane, and only 3 cases remained melanocytes decreased after fusing. Table scar, 9 cases of wound healing after healed left scar weight with pigment fade. Fifteen cases (including partial conservative and partial surgical cases) had no scar after wound healing in 5 cases, 5 cases left flat and soft parchment-like scar, 5 cases left with varying degrees of hypertrophic scar; 3 cases of artificial dermis + Thick skin graft scalp defects + skull defects were left flat, soft, with the same color scar skin with alopecia, the deep skull defects have been cured. CONCLUSION Congenital skin defect wound covering film is poorly developed epidermis, which has the effect of promoting wound healing. Conservative treatment of less than 10% of the wounds can achieve the ideal wound healing effect, but the film covering the surface is needed to be completely preserved. More than 10% A long time to avoid the occurrence of complications recommended large blade thick skin graft closed; with skull defect wound without treatment of bone defects.