To investigate the clinical effect of double layer artificial dermis combined with autologous blade thick skin transplantation in repairing the exposed bone or tendon wounds after burn trauma.

Sixty patients with bone or tendon exposure after burn trauma admitted to the Department of Burn, Inner Mongolia Baogang Hospital from November 2019 to August 2022 meeting the inclusion criteria were selected as the research objects, and their case data were retrospectively analyzed. According to different wound repair methods, the patients were divided into control group and observation group, 30 cases in each group. After admission, relevant examinations were performed, penicillin antibiotics were routinely used to control infection, and antibiotic use was adjusted according to the results of wound bacterial culture and drug sensitivity test. Observation group received surgical debridement and double layer artificial dermal transplantation at stage Ⅰ; after the artificial dermis was completely vascularized, the silicone layer of the artificial dermis was removed in the stage Ⅱ, the wound was trimmed again, and the autologous thick blade skin was transplanted. The control group underwent simple skin flap or skin graft after the wound was equipped with skin grafting conditions. The survival rate of skin or flap, wound healing rate, hospital stay, hospital expenses and scar growth condition were compared between the 2 groups. Data were compared by t test and chi-square test.

Ten days after surgery, all the skin grafts in the observation group survived without subcutaneous congestion and effusion, and the survival rate of skin grafts was 100%; in the control group, 4 skin graft patients had obvious subcutaneous congestion, skin dissolution and necrosis, and 2 skin flap graft patients had partial flap distal blood circulation disorder and ischemic necrosis, the survival rate of skin/flap was 80%, the difference was statistically significant (χ²=4.63, P=0.03). Twenty-eight days after surgery, all wounds in the observation group were healed, and there was no effusion or redness in the operative area, and the wound healing rate was 100%; in the control group, 6 patients had incomplete wound healing, and the wound healing rate was 80%, the difference was statistically significant (χ²=4.63, P=0.03). The average length of hospital stay and the average hospital cost of stay in the observation group were (28.31±3.39) days and (6.58±1.21) yuan, respectively. The average length of hospital stay and the average hospital cost of stay in the control group were (35.42±4.22) days and (3.27±1.10) yuan, respectively. The differences between the 2 groups were statistically significant (t=7.21, 11.13; P< 0.05). Six months after surgery, the score of Vancouver scar scale was (4.72±1.93) points in the observation group and [(5.88±2.12) points] in the control group, and the difference between the 2 groups was statistically significant (t=2.22, P< 0.05).

The treatment of exposed bone/tendon wounds after burn trauma with double-layer artificial derma combined with autologous blade thick skin can improve the survival rate of skin/flap and the rate of wound healing, shorten the average length of hospital stay, and reduce postoperative scar hyperplasia, which is worthy of clinical application.