异体脱细胞真皮基质修补31例腹壁疝及缺损  

USE OF ALLOGENIC ACELLULAR DERMAL MATRIX IN ABDOMINAL WALL HERNIA AND DEFECT REPAIR IN 31 CASES

作　　者：刘飞德[1] 李基业[1] 朱瑛梅[1] 姚胜[1] 王世斌[1] 

机构地区：[1]解放军总医院第一附属医院普外科,北京100048

出　　处：《中国修复重建外科杂志》2010年第10期1253-1256,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的总结应用异体脱细胞真皮基质修补腹壁疝和缺损的临床疗效。方法回顾性分析2007年3月-2009年11月31例应用异体脱细胞真皮基质(商品名:RENOV生物补片)修补腹壁疝及缺损患者的临床资料。男19例,女12例;年龄10～70岁,中位年龄42岁。腹壁肿瘤切除术后腹壁缺损6例,腹壁切口疝补片修补术后感染4例,腹壁切口疝2例,造口旁疝1例,造口旁疝补片修补术后复发1例,回肠代膀胱造口旁疝补片修补术后感染1例,腹股沟疝补片修补术后感染3例,腹股沟疝13例。伴污染或感染创面12例。病程1～34个月,平均6个月。腹壁缺损大小6cm×4cm～19cm×10cm。结果术后29例切口Ⅰ期愈合;1例发生切口中段脂肪液化并形成慢性窦道,1例切口局部裂开补片暴露,均经换药后愈合。31例均获随访,随访时间6～36个月,除1例造口旁疝术后发生膨出外,余患者均无腹壁疝发生或疝复发,无腹壁异物感或慢性疼痛。结论异体脱细胞真皮基质修补腹壁疝和缺损安全、有效,尤其适用于伴污染或感染的腹壁疝及缺损的修补。Objective To summarize the clinical effect of allogenic acellular dermal matrix in repair of abdominal wall hernia and defect. Methods The clinical data were analyzed retrospectively from 31 patients with abdominal wall hernia and defect repaired by allogenic acellular dermal matrix between March 2007 and November 2009. There were 19 males and 12 females with an age range of 10-70 years （median, 42 years）, including 6 abdominal wall defects caused by abdominal wall tumor resection, 4 patchs infection after abdominal wall hernia repair using prosthetic mesh, 2 incisional hernia, 1 parastomal hernia, 1 recurrent parastomal hernia receiving mesh repair, 1 mesh infection caused by parastomal hernia repair using prosthetic patch, 3 mesh infection caused by tension free inguina after hernia repair, and 13 inguinal hernia. There were 12 patients with contaminated or infectious wound. The disease duration was from 1 to 34 months （6 months on average）. The defect size of abdominal wall ranged from 6 cm × 4 cm to 19 cm x 10 cm. Abdominal wall hernia or defect underwent repair using allogenic acelluar demall matrix. Results Of the 31 patients, 29 patients recovered with primary wound healing. Chronic sinus tract occurred in 1 patient and the wound was cured by change dressing. Wound dehiscence and patch exposure occurred in 1 patient, and second healing was achieved after change dressing. All the 31 patients were followed up 6-36 months, no abdominal wall hernia or hernia recurrence occurred in other patients except I patient who had abdominal bulge. And no foreign body sensation or chronic pain in wound area occurred. Conclusion It is feasible and safe to use allergenic acellular dermal matrix patch for repair of abdominal wall hernia or soft tissue defect, especially in contaminated or infectious wound.

关 键 词：生物补片 片体脱细胞真皮基质 腹部疝 腹壁缺损 无张力疝修补 

分 类 号：R656.24[医药卫生—外科学] R628[医药卫生—临床医学]