Lando双层人工真皮在手部皮肤缺损中的应用

目的探讨人工真皮在手部皮肤缺损中的临床应用效果。方法2018年6月-2019年6月,共收治20例手部皮肤缺损伴骨或肌腱外露的患者,所有患者均于一期彻底清创后行VSD负压吸引,待创面无明显感染后采用人工真皮覆盖创面,再次行VSD负压吸引,3周后行自体游离植皮手术,观察人工真皮及自体游离植皮成活情况。结果20例人工真皮及自体游离植皮皮片全部成活,术后随访平均5.6(3~12)个月,骨或肌腱外露均得到良好修复,创面愈合后外形良好,皮肤弹性好,无臃肿及明显瘢痕增生,未见明显色素沉着,外观平整。结论手部创面采用人工真皮修复后成活良好,二期中厚皮片植皮可确保手部皮肤外形美观,弹性好,效果满意。

Application of Lando double layer artificial dermis in hand skin defect

Objective To explore the application of artificial dermis in hand skin defect.Methods The objects of study were 20 cases of hand skin defects with bone or tendon exposure from June 2018 to June 2019.All patients were treated with VSD negative-pressure suction after one-atage thorough debridement.With the identification of no obvious infection in the surface of the wound,artificial dermis was used to cover the wound,followed by another VSD negative-pressure suction.Three weeks later,autogenous skin grafting was performed,after which the survival of artificial dermis and skin graft was observed.Results All 20 cases of artificial dermis and free skin graft survived after operation,with satisfactory repair of the bone or tendon exposure.After wound healing,it had good appearance,excellent skin elasticity and smooth surface,without bloated skin,obvious scar hyperplasia or pigmentation.The average follow-up time was 5.6(3~12)months.Conclusion The hand wound survives well after repairing using artificial dermis.Second stage split-thickness skin grafting can ensure the aesthetic appearance of the hand skin,good elasticity and satisfactory repair effect.