摘要
目的探讨人工真皮(胶原蛋白海绵)联合自体刃厚皮片移植修复老年患者下肢皮肤感染坏死肌腱外露创面的临床效果。方法回顾性分析2017年1月至2019年12月收治的10例下肢皮肤软组织感染坏死后肌腱外露老年患者的临床资料,所有患者均行一期扩创,彻底清除坏死组织,创面持续负压引流治疗,感染控制后种植人工真皮,创面人工真皮肉芽化覆盖肌腱后行自体刃厚皮片移植修复,通过评估创面及取皮区恢复情况综合评价治疗效果。结果 10例患者供皮区取皮后表皮再次形成时间为(13.5±2.5) d,二期手术后行三期植皮时间为(17.5±3.5) d;创面移植皮片均存活良好,肌腱外露创面愈合良好,外观平整;局部瘢痕不明显,整体效果满意。结论人工真皮联合自体刃厚皮片移植治疗老年患者下肢皮肤感染坏死肌腱外露创面,疗效确切。
Objective To investigate the clinical effect of collagen sponge as artificial dermis combined with autologous thin skin graft in repairing the tendon exposed wound of lower extremities caused by skin infection and necrosis in elderly patients.Methods From January 2017 to December 2019,the clinical data of 10 elderly patients with tendon exposure after infection and necrosis of skin and soft tissue in the lower extremities were retrospectively analyzed.All patients alltreated with first-stage expansion,complete removal of necrotic tissue and continuous negative pressure drainage.After the infection was controlled,artificial dermis was implanted.The artificial dermis of the wound was granulated to cover the tendon and then repaired by autologous thin skin graft.The therapeutic effect was evaluated by assessing the recovery of the wound and skin region.Results The reformation time of the epidermis in the donor area of 10 patients was(13.5±2.5)days.The time for the third stage skin grafting after the second stage surgery was(17.5±3.5)days.All skin grafts survived well,the exposed tendon wounds healed well,and the appearance was smooth.Extreme mild scars appeared in the donor area of 2 patients and mild scars occurred in 8 patients.The overall effect was satisfactory.Conclusion Artificial dermis combined with autologous thin skin graft is definitely effective in treating the tendon exposed wound of lower extremities caused by skin infection and necrosis.
作者
王君
井刚
董道全
潘云川
WANG Jun;JING Gang;DONG Daoquan;PAN Yunchuan(Department of Burn and Skin Repair Surgery,Hainan General Hospital(Hainan Affiliated Hospital of Hainan Medical University),Haikou 570311,China.)
出处
《组织工程与重建外科杂志》
2020年第5期374-377,共4页
Journal of Tissue Engineering and Reconstructive Surgery
基金
海南省卫生计生行业科研项目(18A200012)。
关键词
皮肤移植
人工真皮
肌腱外露
Skin transplantation
Artificial dermis
Tendon exposure
