双层人工真皮在手指皮肤皮下组织缺损中的应用  

Application of double-layer artificial dermis in the defect of subcutaneous tissue and skin of digit

作　　者：李中成 丁伟 薛成龙 刘雪涛[1] 刘超[1] 王志红 耿士亮 于子云 LI Zhongcheng;DING Wei;XUE Chenglong(Department of Orthopedic Surgery,The 80th Military Hospital of PLA,Weifang,Shandong,261000,China)

机构地区：[1]中国人民解放军陆军第80集团军医院全军创伤骨科研究所骨科手外一组,山东潍坊261000

出　　处：《实用手外科杂志》2022年第4期431-433,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨应用组织工程产品双层人工真皮修复材料在手指皮肤皮下组织缺损中的临床治疗效果。方法2020年3月-2021年9月,在收治的9例手指皮肤皮下组织缺损的复杂病例中,除应用传统的皮瓣、游离植皮修复创面、残端修整外,还应用了新型组织工程产品双层人工真皮一期修复缺损创面。双层人工真皮不但能保护皮下组织,还能诱导创面肉芽组织及血管等生长,待指体肉芽组织覆盖后创面可行全厚皮游离移植修复。结果本组9例(15指),一期双层人工真皮覆盖三周后指体均见肉芽组织生长良好,二期全厚皮游离移植覆盖创面。一周后更换敷料见8例(13指)完全成活,1例双指部分成活,远端少许坏死,经后期换药创面瘢痕愈合。术后随访2~14个月,平均6个月,观察修复后指体及植皮的外形、功能、肤色、弹性及感觉,均较传统的皮瓣修复及残端修整效果理想,患者及家属满意度明显提高。结论在手指皮肤皮下组织缺损的复杂外伤中应用双层人工真皮一期覆盖创面方法可行,治疗效果较传统皮瓣及残端修整效果满意。Objective To explore the clinical therapeutic effect of tissue engineered product double-layer artificial dermis repair material in the subcutaneous tissue and skin defect of finger.Methods From March,2020 to September,2021,among the complicated patients with subcutaneous tissue and skin defect of finger treated in our department,except for traditional skin flap and free skin graft,the new tissue engineered product,double-layer artificial dermis,was also discussed and applied to repair subcutaneous tissue and skin defect of finger in vitro.On one hand,double-layer artificial dermis could not only protect subcutaneous tissue,but also induced the growth of granulation tissue and blood vessels,and on the other hand,it was expected that all wounds would be covered by granulation tissue of finger body.Results Retrospectively,the number of cases in which the new tissue engineered product,double-layer artificial dermis,was used to repair the subcutaneous tissue defect wound of finger skin in the first stage was 15 fingers in 9 people,including 6 fingers in one finger,2 fingers in both hands and 1 finger in the whole hand.After three weeks of the first-stage double-layer artificial dermis covering,the granulation tissue of fingers grew well,and the second-stage full-thickness skin free transplantation covered the wound.After one week,the dressing was changed,13 fingers in 8 people survived completely,among them,1 finger partially survived and the distal part was slightly necrotic.After dressing change,the wound scar healed,and the average follow-up time was 6 months(February-14 months).By comparing and observing the shape,function,skin color,elasticity and feeling of the repaired finger and skin graft,the effect was better than that of traditional flap repair and finger residual repair,and the satisfaction of patients and their families was significantly improved.Conclusion It is feasible to apply double-layer artificial dermis to cover the wound in one stage in complicated hand trauma with subcutaneous tissue defect of

关 键 词：双层人工真皮 手指 缺损伤 全厚皮 游离移植 皮瓣 分期治疗 

分 类 号：R622[医药卫生—整形外科]