【摘要】 目的 观察Meek微型皮肤移植技术在烧伤外科治疗大面积烧伤深度创面的疗效，探讨其临床使用价值及应用前景。 方法 选择住院治疗的12例大面积深度烧伤患者为研究对象，采用同体对照方法，烧伤创面切削痂后，分别应用Meek植皮技术及传统邮票状皮肤移植技术，在植皮面积与手术人员大致相同的情况下，对两种方法的操作时间、供皮用量、皮片成活率及创面愈合时间等指标进行比较分析。 结果 Meek微型皮肤移植技术与传统邮票状皮肤移植技术比较，前者明显节省手术时间及供皮用量(P<0.05)，创面愈合时间明显缩短(P<0.05)，但皮片成活率无显著性差异(P>0.05)。术后随访3～8月，瘢痕增生程度亦无明显差别。 结论 对于大面积深度烧伤，可采用Meek微型皮肤移植技术取代传统邮票状皮肤移植技术。该技术相对于传统邮票状皮肤移植技术，具有缩短手术时间，节省人力，节省皮源及缩短创面愈合时间等优点，值得临床推广。
【关键词】 皮肤移植; 烧伤; 伤口愈合; 再植术; 真皮
Clinical Application of Meek Skin Grafting Technique to Large Area Deep Burn
WANG Shunbin, WU Boyu, LOU Feihong, YANG Jihui,CHEN Zhaohong, LI Haihui, CHEN Shun, LIN Jianchang
Department of Burn Injury, The Affiliated Union Hospital, Fujian Medical University, Fuzhou 350001, China
ABSTRACT: Objective To investigate the clinical application of Meek skin grafting technique to large area deep burn. Methods Meek skin grafting technique and traditional stamp skin grafting were respectively employed to treat 12 patients with TBSA≥50%. Operating time, amount of donor skin, graft survival, and wound healing time were evaluated and compared between the two techniques. Results Compared with traditional stamp skin grafting, Meek skin grafting technique significantly shortened the operating and wound healing time (P<0.05), and remarkably reduced the amount of donor skin (P<0.05). There was no significant difference in the graft survival rate and scar formation during the 3to8month followup. Conclusion Compared with traditional stamp skin grafting,Meek skin grafting technique uses less donor skin, shorter operating and wound healing time. It is an effective procedure for treating severely burned patients.
KEY WORDS: skin transplantation; burns; wound healing; replantation; dermis
大面积深度烧伤临床抢救治疗难度很大，其原因之一是自体皮源紧缺，加上近几年来异体皮源难求，所以“微粒皮肤移植术+异体皮肤覆盖术”在临床上无法广泛开展。Meek植皮技术在临床的应用解决了上述问题。笔者科室自2007年10月-2009年12月对大面积深度烧伤创面采用Meek微型皮肤移植技术治疗12例，取得较理想疗效，现报告如下。
1 资料与方法
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