人工真皮移植结合自体微型皮柱点阵式种植在修复深度创面的临床效果  

Effect of artificial dermis grafting combined with autologous miniature skin pillar dot seeding on the repair of deep wounds

作　　者：邱加崇[1] 余继超[1] 刘冰峰[1] 范晓鹏 卫家民 袁晓燕 苏丽梅 刘旭盛[2] Jiachong Qiu;Jichao Yu;Bingfeng Liu;Xiaopeng Fan;Jiamin Wei;Xiaoyan Yuan;Limei Su;Xusheng Liu(Department of Burns and Wound Repair,Dongguan Houjie Hospital,Dongguan 523000,China;Department of Burns and Wound Repair,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]东莞市厚街医院烧伤与创面修复科,523000 [2]中山大学附属第一医院烧伤与创面修复科,广州510080

出　　处：《中华损伤与修复杂志（电子版）》2024年第3期231-237,共7页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：东莞市社会发展科技项目(20221800905892)。

摘　　要：目的探讨人工真皮移植结合自体微型皮柱点阵式种植在深度创面的疗效及预后。方法选择东莞市厚街医院烧伤与创面修复科2022年5月至2023年6月收治的14例深度创面患者,其中男8例,女6例;年龄31~86(47.7±10.7)岁。烧冻伤6例,挫擦及抓伤3例,静脉曲张溃疡2例,糖尿病足2例,车祸毁损伤1例。所有患者经彻底清创后,行人工真皮移植结合自体微型皮柱点阵式种植。观察创面愈合及有无复发情况,采用温哥华瘢痕量表(VSS)对瘢痕的色泽、厚度、充血情况、柔软度等进行评分,并计算总分。记录治疗过程中不良反应发生情况。结果14例患者移植微型皮柱成活并扩展融合,创面愈合,住院时间为6~51(22.3±9.9)d,创面愈合时间为12~42(22.2±6.7)d,VSS总分为1~4(2.8±0.7)分,色泽与正常皮肤相近,厚度正常,充血情况不明显,质地柔软,无新增供区损伤、瘢痕挛缩及功能受损。结论人工真皮移植结合自体微型皮柱点阵式种植可有效修复深度创面,无复发,无新增供区损伤,为深度创面治疗提供新的治疗方案。Objective To explore the effect of the repair of deep wounds with grafting of artificial dermis in combination with autologous miniature skin pillar dot seeding.Methods Fourteen patients with deep wounds admitted to Department of Burns and Wound Repair,Dongguan Houjie Hospital from May 2022 to June 2023 were enrolled in the study including 8 males and 6 females,with the mean age of 31-86(47.7±10.7)years.Six patients got burns and frostbite,3 patients got contusions and scratchs,2 patients got varicose ulcers,2 patients got diabetic foot,and 1 patient got car accident damage.All the wounds were covered by artificial dermis in combination with autologous miniature skin pillar dot seeding after debridement thoroughly.Wound healing and recurrence were observed.Vancouver scar scale(VSS)was used to score the pigmentation,height,vascurity and pliability of scars,and the total score was calculated.Adverse reactions during the treatment process were recorded.Results All the grafted miniature skin pillar of fourteen patients were survived and fused,and the wounds were healed.The hospital stay was 6-51(22.3±9.9)days,and the wound healing time was 12-42(22.2±6.7)days.The total score of VSS was 1-4(2.8±0.7)points.The color was similar to that of normal skin,the thickness was normal,the hyperemia was not obvious,and the texture was soft.There was no injury of donor site,scar contracture or dysfunction of the operating area after the operation.Conclusion Deep wounds can be satisfactorily repaired by grafting of artificial dermis in combination with autologous miniature skin pillar dot seeding with no injury of donor site or recurrence after the operation,which provides a new type of therapy for the management of deep wounds.

关 键 词：人工真皮 深度创面 微型皮柱 点阵式 

分 类 号：R622[医药卫生—整形外科]