The Clinical Effect And Histologic Analysis Of Expanded Full-thickness Skin

Objective:To study the clinical effect and histological analysis of expanded full-thickness skin in the reconstruction of scar contracture caused by extensive burns.Methods:This study involved 33 patients who suffered scar contracture and received treatment in the hospital from 2009.01 to 2011.03. The expander was palced in 17 cases, inflated by injecting saline regularly and removed after 3-4 months. The proposed full-thickness skin was designed according to the recipient areas and then grafted.6 cases received intermediate-thickness skin graft.5 cases received full-thickness skin graft. And 5 cases received acellular dermal matrix with razor-thin autograft. All patients were followed up for at least 6 months and we got some pieces of the expanded full-thickness skin,3 cases at the third month after the transplantation and 4 cases at the sixth month. We got 2 samples each for other teams.Result:At the third month after grafted, the expanded flap was dark-red, hard and with poor elasticity. But at the sixth month, the color, elasticity, appearance and function were all improved. The effect was similar to full-thickness autograft.Superior to intermediate-thickness autograft and ADM complex skin. Histological analysis showed that the layer number of epidermal cells increased, the basal cells arranged more regularly, the dermis became thicker and so on. Conclusions:The long term effect is similar to full-thickness autograft, but it is superior to intermediate-thickness autograft and ADM complex skin. The expanded full-thickness skin is a good choice to treat scar contracture caused by extensive burns.