移植异体脱细胞真皮基质后二期行自体皮移植联合封闭负压引流修复肌腱外露创面  

Repairing Tendon Exposed Wounds by StageⅡAutologous Skin Transplantation Combined with Vacuum Sealing Drainage after Transplantation of Allogenic Acellular Dermal Matrixon

作　　者：牛大伟 韩志新 李振超[1] 樊昌伟 NIU Da-wei;HAN Zhi-xin;LI Zhen-chao;FAN Chang-wei(Department of Burn and Plastic Surgery,Anyang People’s Hospital,Anyang 455000,Henan,China)

机构地区：[1]河南省安阳市人民医院烧伤整形外科,河南安阳455000

出　　处：《中国美容医学》2021年第12期1-5,共5页Chinese Journal of Aesthetic Medicine

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20191274);安阳市科技攻关计划项目(编号:2021C01SF047)。

摘　　要：目的:探讨异体脱细胞真皮基质联合自体皮移植和负压引流技术治疗肌腱外露创面的修复效果。方法:回顾性分析笔者医院2017年1月-2020年1月收治的14例不同原因导致的肌腱外露患者的临床资料,所有患者一期行异体脱细胞真皮基质移植覆盖外露肌腱,二期行自体刃厚皮移植,配合使用封闭负压引流技术。观察ADM存活情况、两次手术间隔时长、自体皮片成活率、创面愈合总时间、住院费用,随访3月时植皮区外观情况。结果:14例患者移植的ADM全部成活,两次手术平均间隔时长为(8.5±0.9)d,自体皮片成活率(97.0±2.7)%,创面平均愈合时间为(28.7±3.3)d,供皮区平均愈合时间为(8.4±1.3)d,平均住院费用(2.2±0.3)万元,术后3个月随访外形良好、皮肤无反复破溃。结论:移植脱细胞真皮基质后二期行自体皮移植联合负压引流技术修复肌腱外露创面,符合创面床准备原则,缩短了治疗时间,减少了对患者的损伤,为小面积肌腱外露创面的修复提供了一种可行策略。Objective To investigate the effect of allogeneic acellular dermal matrix combined with autologous skin transplantation and negative pressure drainage and in the treatment of tendon exposed wound.Methods Betwwen January 2017 and January 2020,a total of fourteen patients with tendon exposed were analyzed retrospectively.All patients underwent acellular dermal matrix transplantation firstly,and in the second stage,autologous skin grafting combined with vacuum sealing drainage were actualized to repair wounds.Then the survival rate of ADM,the time interval between two operations,the survival rate of the autologous skin grafting,the wound healing period,the total hospital cost,and the rupture of the skin graft after 3 months follow-up were observed.Results In the 14cases,the average survival rate of ADM was 100%,the average interval of two operations was(8.5±0.9)day,the average survival rates of autologous kin graft was(97.0±2.7)%,the average wound healing time after skin grafting was(12.3±1.8)day,the average healing time of donor site was(8.4±1.3)day,the average total hospital cost was(2.2±0.3)ten thousand yuan,and got satisfactory appearance without recurrent skin ulcer in 3 months follow-up.Conclusion Repairing tendon exposed wounds by stageⅡautologous skin transplantation combined with vacuum sealing drainage after transplantation of allogenic acellular dermal matrixon accord with the principle of wound bed preparation,shorten the treatment time,reduces the injury to the patient and it provides a feasible strategy for the repairing of the wound with small area tendon exposure.

关 键 词：脱细胞真皮基质 自体皮移植 封闭负压引流 肌腱外露 创面 

分 类 号：R622.1[医药卫生—整形外科]