[Effectiveness evaluation of composite skin grafts in repairing deep burn wounds in functional regions].

OBJECTIVE: To evaluate the long-term effectiveness of composite grafts of acellular dermal matrix (ADM) and autologous split-thickness skin in repairing deep burn wounds. METHODS: Between June 2002 and December 2008, 30 patients (42 wound) were treated. There were 25 males and 5 females, aged 3-52 years with a median age of 31 years. Of them, 24 burned patients had 35 wounds, including 23 deep second degree and 12 third degree wounds with a mean disease duration of 24 days (range, 3-45 days); 6 patients with hyperplastic scar had 7 wounds with a mean disease duration of 16 days (range, 9-21 days). The wound locations were neck (2 wound), hand (4 wounds), forearm and elbow (8 wounds), shoulder (3 wounds), peoples (6 wounds), laps (4 wounds), ankle and legs (15 wounds), and the area of wounds ranged from 10 cm x 10 cm to 30 cm x 20 cm. After thorough debridement, tangential excision, and scar excision, ADM and autologous split-thickness skin graft were used to repair the wounds by one-step method. RESULTS: After operation, composite skin graft survived completely in 39 wounds of 27 patients, with a survival rate of 92.9%; partial necrosis occurred in 3 wounds of 3 patients (7.1%), and healed after dressing change and secondary skin graft. The patients were followed up 30-34 months (mean, 32 months) postoperatively. The appearance of the composite grafts were smooth and soft with good elasticity and low pigmentation. The activity and function of limbs recovered well. No scar hyperplasia was observed at the donor sites. CONCLUSION: It can achieve good outcomes in appearance and function to use ADM and autologous split-thickness skin graft for repairing deep burn wounds in functional regions.