自体脂肪浓缩物联合刃厚皮片移植修复静脉性溃疡的可行性及效果  

Application of autogenous adipose concentrate combined with split-thickness skin graft in repair of venous ulcer

作　　者：张剑 梁伟强[1] 张金明[1] 张佳琦[1] 肖小莲 苏正[1] 刘蒙 Zhang Jian;Liang Weiqiang;Zhang Jinming;Zhang Jiaqi;Xiao Xiaolian;Su Zheng;Liu Meng(Department of Plastic Surgery,Sun Yat-sen Memorial Hospital,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院整形外科,广州510120

出　　处：《中华医学美学美容杂志》2019年第6期485-487,共3页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的探讨自体脂肪浓缩物联合刃厚皮片移植修复静脉性溃疡的可行性及效果。方法2015年1月至2018年12月,中山大学孙逸仙纪念医院整形外科收治16例(男10例,女6例;年龄49~72岁,平均56.3岁)静脉性溃疡患者,均行局部清创及换药等对症支持治疗,待肉芽组织生长良好后,用自体脂肪浓缩物联合刃厚皮片移植修复。结果16例患者移植皮片均成活良好,术后2周移植皮片成活率86%~99%。16例均随访6个月,随访期内创面均愈合,1例愈合后因反复摩擦出现局部溃疡复发,经换药治疗后痊愈;15例皮片移植区瘢痕增生不明显,愈合良好。结论自体脂肪浓缩物应用联合刃厚皮片移植可有效提高皮片成活率,是修复静脉性溃疡的一种有效方法。Objective To explore the feasibility and clinical effect of autologous fat concentrate combined with split-thickness skin grafts in the repair of venous ulcer.Methods From January 2015 to December 2018,a total of 16 patients diagnosed with venous ulcer were admitted to our department,and all patients received symptomatic and supportive treatment such as local debridement and dressing change.After the granulation tissue grew well,all patients received autologous adipose concentrate combined with spilit-thickness skin graft for repair.Results All the grafted skin survived well,and the survival rate of grafted skin at 2 weeks after surgery was 86%to 99%.All patients were followed up to 6 months after surgery.The wounds of all patients were healed during the follow-up period.One patient suffered local ulcer recurrence due to repeated friction after healing and the ulcer recovered after dressing changing treatment.All the other patients had no recurrence during the follow-up period.The scar hyperplasia in the skin transplantation area was not obvious and the healing quality was good.No significant surgical complications occurred.Conclusions Autologous lipoconcentrate combined with split-thickness skin grafts is an effective and safe method in the repair of venous ulcer,and the application of autologous lipoconcentrate can effectively improve the survival rate and healing quality of skin grafts.

关 键 词：溃疡 静脉 修复外科手术 自体脂肪浓缩物 刃厚皮片移植 

分 类 号：R47[医药卫生—护理学]