| Background:Deep burns will involve the dermal tissue of the body.If the functional parts are not treated promptly and effectively,it is easy to cause serious unstable scar and limb contracture deformity,which seriously affects the quality of life and prognosis of patients.Cicatricial contracture deformity will not only restrict the range of motion of the damaged joints,but also cause dislocation of the adjacent anatomical structures,which damages the normal appearance of the human body and the physiological function of the related organ system.Meanwhile,it is accompanied by discomfort such as pain,itching and paresthesia,which seriously affects the daily life and physical and mental health of the patient,and compensatory overuse of the surviving joints.Other secondary damages may also be caused,further increasing the risk of mental disorders such as depression and anxiety.Therefore,it is urgent to treat cicatricial contracture deformity.At present,human acellular allogeneic dermis(HADM)as a tissue engineering material has been applied in the repair of scar contracture,and the effect has been confirmed.Objective:To explore the efficacy of acellular allogeneic dermis combined with blade-thickness skin in the repair of cicatricial contracture deformity of joints,so as to provide reference for the surgical plans for such patients.Materials and Methods:A total of 62 patients with joint scar contracture deformity admitted to the Burn and Plastic Surgery Department of Jinan Central Hospital from June 2020 to January 2023 were selected as the research objects.According to the method of intraoperative skin grafting,they were divided into control group and observation group.According to the inclusion and exclusion criteria,there were 24 cases in the observation group and 31 cases in the control group.The observation group was treated with HADM combined with autologous blade-thickness skin,while the control group was treated with full-thickness skin.The differences in skin survival rate,healing time of skin graft area,healing quality of skin graft area,healing time of donor area,postoperative VSS score of skin graft area,degree of joint function recovery,subjective satisfaction,the length of the stay and hospitalization costs were compared between the two groups.Results:(1)The skin survival rate was 96.8%in the control group and 95.8%in the observation group,with no statistical significance between groups(P>0.05).(2)Healing time of skin graft area:control group(7.33±1.98)days,observation group(11.63± 1.61)days,the difference between groups was statistically significant(P<0.001),observation group skin healing time was long.(3)Healing quality of the skin graft area:Grade I healing rate was 93.5%in the control group and 95,8%in the observation group,with no statistical significance between groups(P>0.05).(4)Healing time of the donor site:control group(13.3911.31)days,observation group(10.42±1.59)days,the difference between the groups was statistically significant(P<0.001),the healing time of the donor site in the observation group was short.(5)VSS score after skin grafting:control group was(5.61 ±3.38),observation group was(4.71±2.79),there was no statistical significance between groups(P>0.05).(6)Excellent and good rate of joint function recovery:96.8%in the control group and 95.8%in the observation group,with no statistical significance between groups(P>0.05).(7)Subjective satisfaction survey:the qualified rate of satisfaction was 74.2%in the control group and 95.8%in the observation group,the difference between groups was statistically significant(P<0.001),and the observation group was highly satisfied.(8)Hospitalization cost:control group(3.59±1.13)ten thousand yuan,observation group(4.92±1.14)ten thousand yuan.The difference between groups was statistically significant(P<0.001),and the observation group had a higher cost.(9)Length of hospitalization:control group(23.16±7.96)days,observation group(25.25±7.61)days.There was no statistical significance in length of hospitalization between the two groups(P>0.05).Conclusion:HADM combined with autologous blade-thickness skin has the similar therapeutic effect as full-thickness skin in releasing scar contracture deformity of joints,and can improve patients’ satisfaction,which has important clinical value. |
