胶原蛋白海绵人工真皮在皮肤鳞状细胞癌创面修复中的应用

目的：探讨胶原蛋白海绵人工真皮在修复鳞状细胞癌切除后深度皮肤软组织缺损中的应用。方法：选择下肢皮肤鳞状细胞癌患者11例，均术前活检证实，术中按无瘤原则切除清创后，凿除外露骨皮质，将胶原蛋白海绵人工真皮覆盖缝合，外敷持续封闭式负压固定，3周后取自体薄皮片移植于其上，7天后更换负压装置并观察。结果：11例患者鳞癌切除后5例胫骨外露，3例肌腱外露，胶原蛋白海绵人工真皮覆盖后肉芽组织增生迅速，深部组织良好覆盖，均于首次术后21天左右行Ⅱ期植皮手术，创面愈合良好。结论：胶原蛋白海绵人工真皮应用于鳞状细胞癌切除后深度皮肤软组织缺损的修复效果良好，操作简便，局部损伤小，愈后瘢痕增生轻微，利于肿瘤后期治疗，且不增加供皮区瘢痕。

Clinical application of Collagen sponge artificial dermis in repairing the wound after skin squamous cell carcinoma resection

Objective To study the effect of Collagen sponge artificial dermis in repairing deep skin and soft tissue deficiency after skin squamous cell carcinoma resection. Methods A total of 11 patients with skin squamous cell carcinoma of lower limb from our ward were selected. All patients had a certain pathological diagnosis before surgery. We used non-neoplasma touch technology all through the surgery. After the debridement, we removaled the cortex of the exposed bone, and sutured the Collagen sponge artificial dermis on the wound, fixed the artificial dermis with continuous negative pressure equipment for 21days （observe the wound condition per 7days）, and then did the autologous split-thickness skin transplantation. Results There were 5 patients with tibia exposure and 3 patients with tendon exposure after the Squamous carcinoma resection. After using the Collagen sponge artificial dermis for 21days, the exposed tissues were covered by the fast-growing granulation tissues, all of them received the skin transplantation then, and the wounds healed well after several days. Conclusions The effect of Collagen sponge artificial dermis in repairing deep skin and soft tissue defect after skin squamous cell carcinoma resection is good, and it is easy to be handled. The treatment is less damage and the scar of both wound and donor site are subtle so it is good for the late carcinoma treatment.