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Применение расщепленных сетчатых лоскутов
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Применение расщепленных сетчатых лоскутов

Warning: file_put_contents(): Only 0 of 1420 bytes written, possibly out of free disk space in /var/www/filosof/data/www/medservices.info/wp-content/plugins/wp-optimize-by-xtraffic/Application/Service/PepVN_Cache.php on line 684 Warning: file_put_contents(): Only 0 of 128 bytes written, possibly out of free disk space in /var/www/filosof/data/www/medservices.info/wp-content/plugins/wp-optimize-by-xtraffic/Application/Service/PepVN_Cache.php on line 684 Warning: file_put_contents(): Only 0 of 115 bytes written, possibly out of free disk space in /var/www/filosof/data/www/medservices.info/wp-content/plugins/wp-optimize-by-xtraffic/Application/Service/PepVN_Cache.php on line 684 Warning: file_put_contents(): Only 0 of 128 bytes written, possibly out of free disk space in /var/www/filosof/data/www/medservices.info/wp-content/plugins/wp-optimize-by-xtraffic/Application/Service/PepVN_Cache.php on line 684 Warning: file_put_contents(): Only 0 of 110 bytes written, possibly out of free disk 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by admin06.08.2015
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Применение расщепленных сетчатых лоскутов приводит к значительному увеличению площади трансплантата, поэтому для закрытия умеренной величины дефекта бывает достаточно провести 2-3 оперативных вмешательства, следующих одно за другим через 3-5 дней. При пластике ожоговой поверхности сетчатыми трансплантатами сокращаются сроки трансплантации и возможен более быстрый переход к мерам реабилитации, что способствует значительному снижению частоты развития контрактур и улучшает функциональные результаты лечения.

При обширных ожогах в большинстве случаев приходится прибегать к повторным, множественным трансплантациям, при которых соответственно возрастает риск интеркуррентных фатальных осложнений, это особенно часто наблюдается при ожогах, превышающих 50% поверхности тела. В таких случаях особенно важно закрыть ожоговые раны в самый кратчайший срок, для чего приходится повторно использовать зажившие донорские места. Обстоятельства заставляют срезать более тонкие трансплантаты, хотя хорошо известно, что наиболее полноценный покров восстанавливается при пересадке лоскутов, содержащих большее количество коллагеновых и эластических волокон, обеспечивающих прочность и выносливость аутодермотрансплантатов.

При экстенсивных ожогах ресурсы непораженной кожи, годной для аутопластики, естественно, резко ограничены, поэтому донорские места приходится использовать повторно по мере их заживления. Повторное взятие кожи практически становится возможным через 10-12 дней у взрослых и через 8 дней у детей. Учитывая сходство заживления донорских участков после срезания тонких слоев кожи с заживлением поверхностных ожогов, некоторые авторы рекомендуют использовать в качестве донорских участков также кожу на месте заживления поверхностных ожогов. U. Mariani с успехом применил расщепленные трансплантаты, взятые в области заживших поверхностных ожогов у 28 из 30 больных. Время, прошедшее с момента ожога до использования зажившей ожоговой поверхности, колебалось в пределах 26-195 дней. Автор подчеркивает сходство в приживлении кожных трансплантатов, взятых в области зажившей ожоговой раны и взятых с неповрежденных участков тела. Скорость приживления тех и других, их эластичность, консистенция и мобильность были аналогичны. Характерные для заживления поверхностных ожогов гипохромные участки обеспечивали лучший эстетический эффект по сравнению с пигментированными трансплантатами, полученными со здоровой кожи, что важно при трансплантации и кистях. В критических ситуациях при нехватке донорских участков и отсутствии ожога головы можно с успехом использовать кожу, покрывающую волосистую , это обычно не нарушает роста волос.

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