双层人工真皮治疗手部皮肤缺损伴肌腱、骨质外露  

The double-layer artificial dermis for treatment of hand skin defect with tendon and bone exposure

作　　者：潘露 常景辉 王伟 白雪 PAN Lu;CHANG Jing-hui;WANG Wei;BAI Xue(SectionⅡ,Dept of Microhand Surgery,the Orthopaedic Hospital of Nanyang City,Nanyang,Henan 473000,China)

机构地区：[1]南阳市骨科医院显微手外二科,河南南阳473000

出　　处：《临床骨科杂志》2023年第4期533-536,共4页Journal of Clinical Orthopaedics

摘　　要：目的 探讨双层人工真皮修复手部皮肤缺损伴肌腱、骨质外露的疗效。方法 采用双层人工真皮治疗24例手部皮肤缺损伴肌腱、骨质外露患者,术后根据创面缺损大小与位置选择是否再行中厚自体皮片移植。结果 患者均获得随访,时间2~12个月。术后3周,人工真皮全部获得血管化,并形成了淡红色类真皮样组织。11例未行自体皮片移植,术后20~37 d创面自然上皮化爬行愈合。13例采用中厚自体皮片移植,术后2周创面愈合良好,外形美观,质地柔软有弹性。末次随访时,24例患者指间关节及掌指关节活动均恢复正常,患者对治疗效果均满意。结论 双层人工真皮是修复手部皮肤缺损伴肌腱、骨质外露的良好方法,手术操作简便,创伤小,较小的缺损面积无需行游离皮片移植,避免了额外手术创伤及风险,能够较好地恢复患肢(指)外形及功能。Objective To investigate the effect of double-layer artificial dermis in repairing hand skin defect with tendon and bone exposure.Methods The 24 cases of hand skin defects with tendon and bone exposure were treated with double-layer artificial dermis,after the operation,medium thickness autologous skin graft was selected to graft according to the size and location of wound defect.Results All patients were followed up for 2~12 months.At 3 weeks postoperation,all the artificial dermis were vascularized,and formed reddish dermoid tissue.The 11 cases were not performed with the autologous skin graft,and the wound surface was naturally epithelialized and clawing healed at 20~37 d after surgery.The 13 cases were adopted with medium thickness autologous skin grafts,and the wounds healing were good at 2 weeks postoperation,the appearance was beautiful,the texture was soft and elastic.At the last follow-up,the interphalangeal joint and metacarpophalangeal joint activities were restored to normal in the 24 patients,and all patients were satisfied with the therapeutic effect.Conclusions The double-layer artificial dermis is a good method to repair the skin defects of the hands of patients with tendon and bone exposure,the operation is simple,less trauma,the smaller defect area does not require free skin graft,and which avoid additional surgical trauma and risk,and can better restore the appearance and function of the affected limb(finger).

关 键 词：手外伤 人工真皮 皮肤缺损 肌腱骨质外露 

分 类 号：R658.2[医药卫生—外科学] R622.1[医药卫生—临床医学]