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中华损伤与修复杂志(电子版) ›› 2023, Vol. 18 ›› Issue (06) : 498 -502. doi: 10.3877/cma.j.issn.1673-9450.2023.06.008

论著

网状植皮与ReCell表皮细胞种植在深Ⅱ度烧伤治疗中的疗效对比
王成, 张慧君, 覃凤均, 陈辉()   
  1. 100035 首都医科大学附属北京积水潭医院烧伤科
  • 收稿日期:2023-04-10 出版日期:2023-12-01
  • 通信作者: 陈辉
  • 基金资助:
    北京积水潭医院"学科骨干"计划专项经费资助项目(XKGG202114); 北京积水潭医院"自然基金培育计划"资助项目(ZR-202208)

Comparation of efficacy on meshed skin grafting and ReCell epidermal cell transplantation in the treatment of deep second degree burns

Cheng Wang, Huijun Zhang, Fengjun Qin, Hui Chen()   

  1. Department of Burns, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China
  • Received:2023-04-10 Published:2023-12-01
  • Corresponding author: Hui Chen
引用本文:

王成, 张慧君, 覃凤均, 陈辉. 网状植皮与ReCell表皮细胞种植在深Ⅱ度烧伤治疗中的疗效对比[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 498-502.

Cheng Wang, Huijun Zhang, Fengjun Qin, Hui Chen. Comparation of efficacy on meshed skin grafting and ReCell epidermal cell transplantation in the treatment of deep second degree burns[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2023, 18(06): 498-502.

目的

对比网状植皮与ReCell表皮细胞种植在深Ⅱ度烧伤治疗中的效果。

方法

选择2019年1月至2022年1月首都医科大学附属北京积水潭医院烧伤科收治的符合入选标准的40例深Ⅱ度烧伤患者作为研究对象。按照随机的原则,分为试验组和对照组,试验组应用ReCell表皮细胞种植技术治疗,对照组应用网状植皮技术(1∶2)治疗。术后创面给予定期观察评估,拍照。比较两组创面愈合时间、供皮区面积、手术时间、术后疼痛、术后瘢痕情况。数据比较采用t检验及χ2Fisher精确检验。

结果

本研究纳入20例ReCell表皮细胞种植组和20例网状植皮组患者。两组之间在年龄、性别、烧伤面积等基线特征方面差异无统计学意义。试验组的创面愈合时间为(15.3±2.3)d,对照组的创面愈合时间为(18.5±3.5)d,两组之间差异有统计学意义(P<0.05)。修复相同100 cm2创面,试验组的供皮区面积为(1.8±0.2)cm2,对照组的供皮区面积为(48.3±2.9)cm2。试验组平均手术时间为(45.3±6.3)min,对照组平均手术时间为(50.4 ± 9.9)min,两者差异无统计学意义。在手术后1、3、7 d,试验组患者的疼痛指数明显低于对照组(P<0.05)。在术后3、6、9、12个月的随访中,试验组患者瘢痕得分明显低于对照组(P<0.05)。尤其是在术后9、12个月时,两组间的差异更加显著。

结论

ReCell表皮细胞种植技术相对于网状植皮技术在深Ⅱ度烧伤治疗中具有更短的创面愈合时间、较小的供皮区面积、更少的术后疼痛和瘢痕形成的优点,且手术时间无显著差异。ReCell表皮细胞种植技术是一种有效的深Ⅱ度烧伤治疗方法,可以提高患者的治疗效果。

Objective

To compare the efficacy of meshed skin grafting and ReCell epidermal cell transplantation in the treatment of deep partial-thickness burns.

Methods

A tatal of 40 patients with deep partial-thickness burns who were admitted to the Department of Burns at Beijing Jishuitan Hospital, Capital Medical University from January 2019 to January 2022 and met the inclusion criteria were randomly divided into a study group and a control group. The study group received treatment with ReCell epidermal cell transplantation, while the control group received treatment with meshed skin grafting (1∶2). Postoperative wound observation and evaluation were performed at regular intervals and photographs were taken. The healing time, donor site area, operation time, postoperative pain, and postoperative scar formation were compared between the two groups. Data were analyzed using t test and χ2 or Fisher test.

Results

This study included 20 patients in the ReCell epidermal cell transplantation group and 20 patients in the meshed skin graft group. There was no statistically significant difference between the two groups in baseline characteristics such as age, gender, and burn area.The healing time was (15.3±2.3)d in the study group and (18.5±3.5)d in the control group, and there was a significant difference between the two groups (P<0.05). For the same repaired 100 cm2 wound, the donor site area was (1.8±0.2)cm2 in the study group and (48.3±2.9) cm2 in the control group. The average operation time was (45.3±6.3)min in the study group and (50.4±9.9)min in the control group, and there was no significant difference between the two groups. Postoperative pain: on postoperative day 1, 3, and 7, the pain index of the study group was significantly lower than that of the control group (P<0.05). Postoperative scar formation: in the follow-up at 3, 6, 9, and 12 months after surgery, the scar score of the study group was significantly lower than that of the control group (P<0.05), especially at 9 and 12 months after surgery.

Conclusion

ReCell epidermal cell transplantation has a shorter healing time, smaller donor site area, less postoperative pain and scar formation compared to meshed skin grafting in the treatment of deep partial-thickness burns, and there is no significant difference in operation time. ReCell epidermal cell transplantation is an effective treatment for deep partial-thickness burns, which can improve the therapeutic effect.

图1 ReCell表皮细胞种植技术修复深Ⅱ度烧伤创面。A示深Ⅱ度烧伤创面;B示应用ReCell制备表皮细胞悬液;C示将表皮细胞悬液喷洒到清创后的烧伤创面;D示术后烧伤创面愈合情况
表1 两组患者一般资料比较
表2 两组患者术后疼痛评分比较(分,±s)
表3 两组患者术后瘢痕评分比较(分,±s)
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