| Background and Objective:In the treatment of burn and plastic patients, due to its own structural characteristics of intermediate split thickness skin graft, which is containingepidermis and part of dermis, with strong vitality, softness after survival and the ability of tolerating friction and weight,it had been widely used in the clinical work,.But the scarring atthe donor site was a new problem. Althoughnumerous studies about this problem had been reported, there was still not a solution accepted by majority ofresearchers.The children’sskin structure was different from adults’, and the thickness of their skin was thinner than adults, so the donor site of the intermediate split-thickness skin was more easily to form scar at early time. At the same time, since current researchesmainly aimed at adults, the research for the skinwound repair was little about children. By transplanting razor-thin graft to the the donor site of intermediate split-thickness skin;,we tried to observe clinical effect of comprehensive treatment on the prevention against the scarring at the donor site of intermediate split-thickness skin graft. Methods:In this study,the datum of 40 pediatric cases were from patients that were in hospital from September 2013 and June 2015 in our department, and all cases need to accept the transplantation of intermediate split-thickness skin. Among 40 cases, 20 cases usingsplit-thickness skin grafts to the donor site of intermediate split-thickness graft of the children were divided to group A; Other 20 patients without split-thickness skin grafts of children were divided to group B; their age was ranging from 1 to 14 years old.The split-thickness skin grafts of patients in group A coming from the nearby area of the donor site or the head area were used to the donor site, and the outer covering alginate dressings. The donor sites of the control group were covered with alginate dressings after the middle split-thickness skin grafts were taken. The patients of two groups needed to be bandaged with certain amount of pressure in the outer layer of the alginate dressings. The patients of the two groups were given a intermittent infrared heat lamp light, and after the wound of the donor sites were healed for a week, the treat of the pressure and the medication of resisting scar drugs were begun. The condition of donor site of intermediate split-thickness skin graft of two groups were respectively observed in a week and 12 months after operation, and the condition of scar hyperplasia and pruritus of the donor site was compared between both groups in 12 months after operation. Results:1. The healed time of wound at donor site of patients in group A and B were 7.65±3.68 d and 18.20±4.26 d.the difference between group A and B were tested by the statistical test as statistically significant,and P<0.05.2.The score of scar scale of the patients in treatment group A、group B during the 12 months of scar stable period were 4.75±2.15 and 8.35±3.18, the difference between group A and B were tested by the statistical test as statistically significant,and P<0.05.3.The score of pruritus scale of the patients in treatment group during the 12 months of scar stable period was 1.22±0.14, the counterpart of patients in control group was1.48±0.17; the difference was tested by the statistical test as statistically significant and P<0.05. Conclusions:1. The treatment of replantation of razor-thin scalp as an auto graft at donor site of intermediate split-thickness skin graft can markedly shorten the healing time of wound surface in the pediatric patients.2.Replantation of razor-thin scalp serving as an autograft at the donor site of intermediate split-thickness skin graft could be more conducive to alleviate the degree of scar hyperplasia and pruritusat of donor site of intermediate split-thickness skin graft. |
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