人工真皮修复慢性创面疗效观察

目的 探索慢性创面治疗方法.方法 回顾性分析我院2008年至2011年62例慢性创面患者的治疗方法.将其随机分成两组:对照组32例,予抗感染,改善微循环,聚维酮纱外敷,经换药治疗创面未愈者行植皮或皮瓣修复术；观察组30例,予抗感染,改善微循环,早期清创,感染控制后外敷人工真皮(皮耐克),诱导真皮重建,促进肉芽组织生长和创面愈合,创面较大者待其肉芽生长满意后行植皮术.结果 对照组平均住院天数( 58.2±1.3)d,其中植皮或皮瓣修复术修复18例,创面换药愈合者14例,创面愈合后疤痕增生明显.观察组平均住院天数( 31.4±1.1)d,其中7例患者创面较大,经外敷人工真皮,肉芽生长满意后予植皮手术,其余患者经外敷人工真皮、换药,创面治愈后外观满意,疤痕增生轻或不明显.结论 应用人工真皮可促进慢性创面愈合,减少疤痕增生,有效缩短住院天数,降低手术率和手术风险,值得借鉴、推广.

The efficacy of artificial dermis in the repair of chronic wounds

Objective To explore therapies for chronic wounds. Methods The therapies for chronic wounds in 62 patients who had been hospitalized during 2008 to 2011 were retrospectively analyzed. The patients were randomly divided into control group （ 32 patients ） and study group （ 30 patients ）. The control group received anti-infection, microcirculation improvement and their wounds were covered by gauze soaked with povidone iodine cream with regular dressing change; the study group received anti-infection, microcirculation improvement and early debridement and their wounds were covered by artificial dermis （ PELNAC ） to induce dermal reconstruction after infection control and to promote granulation tissue regeneration and/or scar formation and wound healing. Some bigger wounds were treated by skin grafting after satisfied growth of granulation tissues. Results In the control group, the average length of hospital stay was （ 58.2 ± 1.3 ）days; 18 patients were treated by skin grafting or skin flap transplantation for wound healing and the wounds in 14 patients were healed by wound dressing with remarkable scar formation. In the study group, the average length of hospital stay was （ 31.4 ± 1.1 ）days; the wounds in the patients were covered with artificial dermis with little scar formation, 7 of whom with bigger wounds were treated by skin grafting after wound bed preparation （ granulation tissue growth ） by artificial dermis. Conclusions Artificial dermis could accelerate the healing speed of chronic wounds. Wound repair with artificial dermis could shorten length of hospital stay and decrease surgical duration and risks. It is worth popularizing.