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題名 | Uses of Artificial Dermis in Burn Patients from the Formosa Fun Coast Dust Explosion Disaster=人工真皮使用於八仙塵爆病患治療之經驗報告 |
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作 者 | 張鈞凱; 喬浩禹; 王啟宇; 周昌益; 吳建儒; 江奕翰; 王志信; 戴念梓; 陳錫根; 陳天牧; 曾元生; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷期 | 26:1 2017.03[民106.03] |
頁次 | 頁53-61 |
分類號 | 416.141 |
關鍵詞 | 塵爆; 燒傷; 人工真皮; 疤痕鬆解; Dust explosion; Burns; Artificial dermis; Scar release; |
語文 | 英文(English) |
中文摘要 | 背景:2015年台灣發生了史上最嚴重的公安事件—八仙塵爆,約有499位民眾在此事件中被波及而造成不同程度的燒燙傷,這些大量且大面積燒燙傷病人的傷口治療對於整形外科醫師來說是一個挑戰。目的及目標:在此篇文章,我們報告本院使用人工真皮於八仙塵爆燒燙傷病患之各式治療經驗。材料及方法:自2015年6月至2016年9月共使用人工真皮於13位病患身上,我們紀錄了病患之年齡、性別、燒傷面積及深度、使用之人工真皮及目的、使用之位置與大小、以及預後。結果:所有病人都存活,其中五位接受人工真皮作為植皮前準備之病患皆於一次手術後便獲得良好成果;而其中六位接受人工真皮作疤痕鬆解手術之病患皆在外觀及功能上獲得良好恢復,只有一位病患因疤痕孿縮而需再次手術。結論:人工真皮目前已廣泛應用於傷口治療尤其是疤痕孿縮治療方面。人工真皮的許多好處讓整形外科醫師在面對各式傷口時能有更多的治療方式,我們分享報告本院使用人工真皮於這些八仙塵爆嚴重燒燙傷病患之經驗,作為日後治療大量燒傷病患之參考與選擇。 |
英文摘要 | Background: The Formosa Fun Coast Dust Explosion Disaster was the most terrifying disaster in 2015. Overall, there were approximately five hundred patients with burn injuries of varying degrees. This disaster not only affected the patients and their families, but was also a great challenge to our plastic surgeons and the entire National health system. Among these patients, many had significant injuries with extensive burn areas confronting with difficulties in acute intensive care, wound management, and burn scar reconstruction. Objectives: We report our experiences in various clinical applications of artificial dermis (Terudermis®, Nevelia®, Pelnac®) for acute burn patients, preparation of wound beds for autologous skin grafts, and post-burn scar contracture reconstruction. Materials and Methods: Among the 65 patients from the Formosa Fun Coast Dust Explosion Disaster admitted to the Tri-Service General Hospital from June, 2015, to September, 2016, 13 who received artificial dermis-related surgery were included in this report. Demographic data including patients' sex and age, total body surface burn area and burn degree, full-thickness burn area, purpose of artificial dermis use, size and area, and final results were collected. Results: All thirteen patients survived after major burn injuries. Body fluid loss decreased significantly in four patients receiving artificial dermis as coverage for their acute wounds. Successful fluid resuscitation was obtained. Five patients were treated with artificial dermis implantation followed by autologous skin grafting. Good functional results were observed at one-year follow-up. Six patients received artificial dermis for revisions of hypertrophic scar; patients with release of scar contracture had good prognosis in terms of appearance and function. Only one patient had follow-up surgeries on the same area because of recurrent hypertrophic scarring with contracture. Conclusion: Artificial dermis has been widely used in many aspects of wound management, especially in the reconstruction of scar contracture. There are many advantages of artificial dermis, which have made them the workhorse in wound treatment. We have shown that artificial dermis is a good option for treating patients with major burn injuries because it improves survival rate, and enhances wound resurfacing and post-burn scar reconstruction. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。