微粒皮种植术治疗难愈会阴部坏死性筋膜炎1例  

A case of perineal necrotizing fasciitis treated with microskin implantation

作　　者：胡海涛 刘双飞 李志嘉 吉苏云 何仁亮 杨斌[1] HU Haitao;LIU Shuangfei;LI Zhijia;JI Suyun;HE Renliang;YANG Bin(Guangdong Clinical College of Dermatology,Anhui Medical University;Dermatology Hospital,Southern Medical University,Guangzhou 510091,China)

机构地区：[1]安徽医科大学广东皮肤病临床学院 [2]南方医科大学皮肤病医院,广东广州510091

出　　处：《皮肤性病诊疗学杂志》2022年第2期139-142,共4页Journal of Diagnosis and Therapy on Dermato-venereology

摘　　要：报告微粒皮种植术治疗难愈会阴部坏死性筋膜炎1例。患者男,56岁,因“会阴部溃疡、结痂伴疼痛15个月”于我院门诊就诊。皮肤科专科检查:会阴部大片溃疡,大小约25 cm×28 cm,深及肌层,表面可见黑色厚痂缘与周围组织分离,可见黄白色分泌物,周围皮肤呈紫红色。皮损组织病理:部分缺损,出血坏死,缺损区下真皮浅层小血管壁纤维蛋白样变性,炎性细胞浸润,纤维组织增多。结合患者临床表现、组织病理结果,诊断为会阴部坏死性筋膜炎。入院后予以对症支持治疗,同时予以多次会阴部溃疡清创术、持续负压吸引术(VSD)、微粒皮种植术,随后逐渐形成皮岛,皮岛逐渐融合形成皮面,最后覆盖创面。随访2年,患者创面恢复良好,部分瘢痕愈合,目前随访中。A case of refractory perineal necrotizing fasciitis treated by microskin implantation is reported.A 56-year-old male presented with perineal ulcer,crusting and pain for 15 months.Dermatologic examination:large ulcers on the perineum,about 25 cm×28 cm in size,deep to the muscle layer,with a thick black crust separated from the surrounding tissue on the surface,yellow-white secretions,and purple-red surrounding skin.Histopathology revealed partial defect,hemorrhage and necrosis,fibrinoid degeneration of small blood vessel wall in the superficial dermis in the defect area,inflammatory cell infiltration,and increased fibrous tissue.According to clinical manifestations and histopathological results,the patient was diagnosed with perineal necrotizing fasciitis.After multiple perineal ulcer debridement and continuous negative pressure suction(VSD),microskin implantation were performed.Skin island gradually formed and merged to form the skin surface,and finally covered the wound surface.After a 2-year follow-up,the patient′s wounds recovered well and some scars healed.

关 键 词：坏死性筋膜炎 微粒皮种植术 

分 类 号：R47[医药卫生—护理学]