摘要
背景：深度皮肤软组织缺损创面积极的治疗方法往往以皮瓣修复为主，但对患者身体状况要求较高，且代价较大。人工真皮是最早开发和成功应用于临床的组织工程化皮肤替代物，主要用于皮肤软组织缺损的修复。目的：拟观察人工真皮联合自体薄层皮片移植对深度皮肤软组织缺损创面的修复效果。设计、时间及地点：病例分析，于200601／2008—03在北京大学第三医院成形科、北京积水潭医院烧伤整形科完成。对象：11例患者均存在由于手术或外伤导致不同程度和部位的皮肤软组织缺损创面，部分病例伴有骨质外露、骨膜缺损。方法：手术中一期扩创，需要时凿骨，移植人工真皮，经2～4周创面破类真皮组织覆盖后，二期进行自体薄层皮片移植。主要观察指标：观察创面愈合及植皮存活情况，供皮区有无明显瘢痕。结果：11例创面均得到良好覆盖。创面愈合后1个月复查，植皮后愈合良好，供皮区均没有明显瘢痕。结论：人工真皮联合自体薄层皮片移植对深度皮肤软组织缺损创面具有良好的修复效果，供区损伤小。人工真皮的应用为修复包含骨外露创面在内的深度皮肤软组织创面提供了一种新方法。
BACKGROUND： The flap grafting is a commonly restorative procedure for severe defects of skin and soft tissue, but it needs satisfactory physical status with high price. Artificial dermis is a tissue-engineered skin graft that has been developed and successfully applied in clinics, the use of artificial dermis would provide a new way to repair the defect of skin and soft tissue. OBJECTIVE： To study the therapeutic efficacy of repairing defects of skin and soft tissue with artificial dermis and autologous skin graft. DESIGN, TIME AND SETTING： The case analysis was performed in Department of Plastic Surgery, Peking University Third Hospital and Department of Burn and Plastic Surgery, Beijing Jishuitan Hospital from January 2006 to March 2008. PARTICIPANTS： A total of 11 patients were observed, all cases had skin and soft tissue defect due to surgery or trauma, some patients were accompanied with bone exposure and periosteum defect. METHODS： Two phases of surgery were used. Phase 1 surgery involved wound debridement and bone scraps, followed by artificial dermis grafting. After 2 to 4 weeks, phase 2 surgery （autologous thin split-thickness skin grafting） was performed. MAIN OUTCOME MEASURES： The state of wound healing, skin graft survival and scar of skin donor sites. RESULTS： All cases had good coverage of wounds. One month later, the recheck outcome showed that skin graft healing was excellent and donor sites had no obvious skin scar. CONCLUSION： Artificial dermis grafting in combination with autologous thin split-thickness skin graft is effective to repair the defects of skin and soft tissue, with a small injury of donor site. The use of artificial dermis provides a new effective method of repairing defects of skin and soft tissue, including bone-exposing.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第36期7147-7150,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
