猪小肠黏膜下层脱细胞修复补片修复手部软组织缺损的效果分析

目的 对比应用新型再生可降解生物材料猪小肠黏膜下层脱细胞修复补片(SIS)与植皮术在修复手部软组织缺损的治疗效果.方法 2017年12月至2018年12月,共收治手部软组织缺损36例,根据缺损面积与治疗方法分为两组:补片组21例,软组织缺损面积2.0 cm×1.5 cm^9.0 cm×3.5 cm,平均5.3 cm×2.1 cm,采用SIS治疗;植皮组15例,软组织缺损面积9.0 cm×4.0 cm^16.0 cm×9.0 cm,平均12.0 cm×8.5 cm,采用中厚皮片植皮治疗.观察两组治疗方法促进软组织缺损愈合的效果,记录术后14 d、21 d、28 d、3个月创面区愈合情况,并随访评估创面区愈合后的外观、色泽、弹性、感觉恢复与部分肌腱外露的治疗效果.结果 本组36例均获随访,随访时间3~10个月,平均5个月.两组创面均完全愈合,外观、色泽接近,皮肤弹性及感觉均恢复良好.补片组感觉恢复优14例(66.6%),良5例(23.8%),差2例(9.6%);植皮组感觉恢复优9例(60.0%),良4例(26.0%),差2例(14.0%).创面愈合效果补片组优14例,良5例,差2例;植皮组愈合优9例,良4例,差2例.结论 SIS能快速、有效的刺激机体再生出表皮组织,并且新生的表皮经过生长与周围皮肤颜色无明显差异,无明显瘢痕增生,是一种手部小面积浅表软组织缺损的理想修复材料.

Effect of acellular repair patch of small intestinal submucosa of porcine in repairing of soft tissue defects of hand

Objective To compair the outcomes of repairing soft tissue defects of hand between a biodegrad-able repair patch—porcine small intestinal submucosa(SIS)and skin grafting.Methods From December,2017 to December,2018,36 cases of hand soft tissue defect were treated and analyzed retrospectively.According to the defect area and treatment methods,36 cases were divided into 2 groups:SIS group(21 cases)and grafting group(15 cases).In SIS group,the area of soft tissue defects was 2.0 cm×1.5 cm-9.0 cm×3.5 cm with an average of 5.3 cm×2.1 cm,treat-ed with SIS;In grafting group,the area of soft tissue defects was 9.0 cm×4.0 cm-16.0 cm×9.0 cm with an average of 12.0 cm×8.5 cm,treated with autologous skin grafting after wet dressing.Wound healing was evaluated at 14,21 and 28 days,and 3 months after the surgery according to the appearance of colour,elasticity,sensory recovery and prog-noses of partial tendon exposure.Results All patients were followed-up for 3 to 10 months,with an average of 5 months.All wounds in both groups were completely healed;the appearance was normal,and the skin elasticity and sensation had recovered.Sensation recovery in SIS group:14 cases were good(66.6%),5 cases were fine(23.8%),and 2 cases were bad(9.6%);in grafting group:9 cases were good(60.0%),4 cases were fine(26.0%),and 2 cases were bad(14.0%).Wound healing effect in SIS group:14 cases were good,5 cases were fine,and 2 cases were bad;in grafting group:9 cases were good,4 cases were fine,and 2 cases were bad.Conclusion The SIS patch can be used in the reconstruction of soft tissue defects in hand.There was no significant difference in colour compared to the sur-rounding skin and left no scar.The patch is an ideal repair material for superficial skin defects.