皮耐克一期修复伴有骨或肌腱外露的大面积皮肤缺损  

One-stage Pelnac? Reconstruction of Large Skin Defects with Exposed Bone or Tendon

作　　者：施佳 朱海军 卢伟伟 SHI Jia;ZHU Hai-jun;LU Wei-wei(Department of Plastic Surgery,the Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China;Department of Orthopaedics,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院整形外科,武汉430014 [2]华中科技大学同济医学院附属同济医院骨科,武汉430030

出　　处：《骨科》2022年第5期414-417,共4页ORTHOPAEDICS

摘　　要：目的评估皮耐克一期修复伴有骨或肌腱外露的大面积皮肤缺损的治疗效果。方法回顾性分析2017年10月至2020年5月于华中科技大学同济医学院附属同济医院接受皮耐克一期修复手术治疗伴有骨或肌腱外露的大面积皮肤缺损的15例病人的临床资料。病人平均年龄为45.0岁(29~60岁)。记录病人的皮肤缺损大小、住院时间、手术时间、愈合时间和手术并发症,以及病人对于外观的满意度评分和温哥华瘢痕量表(Vancouver scar scale,VSS)评分等指标。结果15例病人皮肤缺损的面积为(41.6±16.8)cm^(2)(16.8~78.4 cm^(2));皮耐克使用面积为(48.3±16.9)cm^(2)(20.2~82.8 cm^(2))。手术时间为(37.5±6.7)min(28~55 min),住院时间为(2.7±0.8)d(2~4 d)。治疗期间,1例病人出现伤口表面感染、3例病人出现皮下血肿以及伤口轻度溃疡,经过换药等常规处理后均愈合。随访时间为(24.0±7.0)个月(12~36个月),治愈时间为(42.9±9.6)d(28~57 d),病人对修复区外观的满意度得分为(80.7±5.7)分(70~90分),VSS得分为(5.7±1.1)分(4~7分)。其中9例病人报告感觉功能正常或接近正常,6例病人报告感觉轻微丧失。结论皮耐克一期修复伴有骨或肌腱外露的大面积皮肤缺损是一种有效、可靠的替代治疗方法,值得临床推广。Objective To assess the outcome of one⁃stage Pelnac®reconstruction of large skin defects with exposed bone or tendon.Methods The clinical data of 15 patients with large⁃area skin defects with exposed bone or tendon who underwent primary repair surgery with Pelnac®in Tongji Hospital from October 2017 to May 2020 were retrospectively analyzed.The average age of the patients was 45.0 years(29⁃60 years).The defect size,hospital stay,operation time,healing time and surgical complications were recorded,as well as the patient􀆳s satisfaction score for appearance and Vancouver Scar Scale(VSS)score.Results The defect size in 15 patients was(41.6±16.8)cm^(2)(16.8⁃78.4 cm^(2)),the area of Pelnac®was(48.3±16.9)cm^(2)(20.2⁃82.8 cm^(2)),the operation time was(37.5±6.7)min(28⁃55 min)and the hospital stay was(2.7±0.8)days(2⁃4 days).During the treatment,1 patient had wound surface infection,3 patients had subcutaneous hematoma and slight ulcer of the wound,and all healed after routine treatment such as dressing change.The follow⁃up time was(24.0±7.0)months(12⁃36 months),the cure time was(42.9±9.6)days(28⁃57 days),the patient􀆳s satisfaction with the appearance of the repair area was(80.7±5.7)(70⁃90),and the VSS score was(5.7±1.1)(4⁃7).Among them,9 patients reported normal or nearly normal sensory function,and 6 patients reported slight loss of sensation.Conclusion Pelnac®dermal templates provide an efficient,reliable alternative to large skin reconstruction in the treatment of wounds with underlying tissue exposure.

关 键 词：大面积皮肤缺损 皮肤移植 骨外露 肌腱外露 

分 类 号：R622[医药卫生—整形外科]