人工真皮复合自体薄皮移植治疗皮肤软组织缺损

背景:修复皮肤软组织缺损自体或异体植皮治疗,往往需要多次植皮.而国内临床上应用人工真皮较少,应用经验亦不足.目的:评价人工真皮治疗皮肤软组织缺损的疗效.方法:收集因皮肤软组织缺损,行人工真皮结合自体薄皮移植修复创面的22 例患者,其中骨外露6 例,肌腱外露2 例,表皮肿瘤切除3 例,其他11 例.一期清创移植人工真皮,2～4 周后局部肉芽组织生长良好,外露肌腱、骨组织被类真皮组织覆盖,二期移植自体薄层皮片.观察取皮部位、损伤部位、操作性能、密封性、不良反应情况,结合评价临床效果及综合评价.结果与结论:20 例患者人工真皮结合二期自体薄皮移植全部存活,至二期植皮所需时间(18.50±4.27) d,其中1 例患者因感染再次手术,2 例患者行人工真皮后未行二期植皮,而自动上皮化;随访至3 个月,21 例损伤部位表皮生长性、外观性均良好、无瘢痕增生,1 例因感染而致瘢痕增生严重、外观不良,但生长性良好;20 例患者取皮部位无明显的色素沉着及色素脱出,无严重增生性瘢痕,上皮形成时间为(15.35±4.67) d.说明人工真皮结合自体薄皮移植修复皮肤软组织缺损,操作简便,创面愈合质量高,供皮区损伤轻微,至二期植皮时间较长,总体临床效果良好.

Artificial dermis combined with autologous thin skin transplantation for repair of soft tissue defects

BACKGROUND:Multiple skin transplantations are needed when repair soft tissue defects by skin grafting.Artificial dermis is rare used in clinic,and the experience is insufficient.OBJECTIVE:To evaluate curative effect of artificial dermis for repair soft tissue defects.METHODS:A total of 22 cases underwent artificial dermis with autologous thin skin transplantation were selected,including 6 cases with bone exposure,2 with tendon exposure,3 with resection of skin tumor,and 11 with others.Debridement and artifi...