脱细胞同种异体真皮联合自体薄层皮修复踝后区跟腱外露皮肤软组织缺损的临床效果  

Clinical outcome of decellularized allogeneic dermis combined with autologous thin-layer dermis for repair of exposed skin soft tissue defects of the achilles tendon in the posterior region of the ankle

作　　者：廖晓霜 曾李 杨波[1] LIAO Xiaoshuang;ZENG Li;YANG Bo(Department of Wound Repair and Burns,Bishan Hospital of Chongqing Medical University,Chongqing City,402760,China)

机构地区：[1]重庆医科大学附属璧山医院创面修复与烧伤科,重庆402760

出　　处：《中国医疗美容》2024年第7期69-73,共5页China Medical Cosmetology

摘　　要：目的探讨应用脱细胞同种异体真皮(human acellular dermal mantrix,HADM)联合自体薄层皮修复踝后区跟腱外露皮肤软组织缺损的可行性和临床效果。方法采用回顾性观察性研究方法。2020年10月至2023年10月,重庆医科大学附属璧山医院收治踝后区跟腱外露皮肤软组织患者10例,其中女3例、男7例;年龄42~75岁,平均56岁,病程1~3个月,平均1.3个月。踝后区跟腱外露彻底清创,多期负压封闭引流术培养创基,清创后遗留创面面积为4.3 cm×4.2 cm~9.0 cm×5.0 cm。使用HADM联合自体皮复合移植修复创面,术后植皮区采用负压封闭吸引,取皮区均无菌敷料加压包扎。术后7 d观察植皮区成活情况,术后14 d观察取皮区创面愈合情况。术后随访时观察患者踝后区外观、瘢痕增生情况、活动情况、皮片收缩情况。结果术后7天所有皮片存活良好。术后14 d所有供区创面愈合情况良好。术后3~6个月随访时,踝后区皮片无收缩,未见明显瘢痕增生,外观不臃肿,活动不受限。结论针对踝后区跟腱外露大面积皮肤软组织缺损,应用脱细胞同种异体真皮联合自体薄层皮修复创面,手术操作简便,术后踝后区外观及功能成功重建,活动不受限,局部皮片均无收缩,修复效果良好。Objective To investigate the feasibility and clinical results of applying decellularized allogeneic dermis(HADM)in combination with autologous thin-skinned dermis to repair exposed skin soft tissue defects of the Achilles tendon in the posterior region of the ankle.Methods A retrospective observational study method was used.From October 2020 to October 2023,10 patients with exposed skin and soft tissues of Achilles tendon in the posterior region of the ankle were admitted to Bishan Hospital affifiliated to Chongqing Medical University,of whom 3 were female and 7 were male;their ages ranged from 42 to 75 years old,with an average of 56 years old,and the duration of the disease ranged from 1 month to 3 months,with an average of 1.3 months.All the Achilles tendon exposed in the posterior ankle area were thoroughly debrided,and the trauma base was cultured by multi-stage negative pressure closed drainage,and the area of trauma left after debridement was 4.3 cm×4.2 cm~4.5 cm×5.0 cm.The trauma was repaired by using HADM combined with autologous dermal composite grafting,and the implanted area was suctioned by negative pressure closure after surgery,and the skin-taking area was bandaged by pressure with aseptic dressings.The survival of the implanted area was observed at 7 d after surgery,and the healing of the skin-taking area was observed at 14 d after surgery.During the postoperative follow-up,the appearance of the posterior ankle area,scar proliferation,activity,and contraction of the skin flflap were observed.Results All skin fragments survived well at 7 d postoperatively.All donor area wounds healed well at 14 d postoperatively.At the 3-to 6-month postoperative follow-up,there was no shrinkage of the skin fragments in the posterior region of the ankle,no obvious scarring,no bloating in appearance,and no restriction of movement.Conclusions For the large skin and soft tissue defects of the exposed Achilles tendon in the posterior region of the ankle,decellularized allogeneic dermis combined with autologous thin-la

关 键 词：脱细胞异体真皮 踝后区 自体薄层皮 创面修复 跟腱 

分 类 号：R658.3[医药卫生—外科学]