摘要
目的:探究双层人工真皮联合外用重组人碱性成纤维细胞生长因子(Recombinant Human Basic Fibroblast Growth Factor,rh-bFGF)在手指端皮肤缺损修复中的应用效果。方法:选取2018年8月-2023年12月笔者医院收治的手指端创伤并进行皮肤缺损修复的70例(96指)患者为研究对象,根据是否采用外用rh-bFGF分为两组。对照组31例(40指)患者彻底清创后,采用双层人工真皮覆盖创面,观察组39例(56指)患者在双层人工真皮覆盖创面基础上采用外用rh-bFGF治疗。记录两组一期愈合情况、愈合时间、温哥华瘢痕量表(VSS)评分及手部功能评分情况。结果:观察组一期愈合率达87.18%,高于对照组的64.52%(P<0.05)。对照组11例患者与观察组5例患者拆除人工真皮硅胶膜后有少量创面残留,均进行植皮手术治疗,两组植皮区成活率均为100%。两组感染率(对照组6.45%,观察组0.00%)比较,差异无统计学意义(P>0.05)。观察组愈合时间为(31.36±3.15)d,短于对照组愈合时间(38.94±3.87)d。术后6个月,观察组VSS各评分均低于对照组(P<0.05);两组手部功能各维度评分比较差异无统计学意义(P>0.05)。结论:双层人工真皮联合外用rh-bFGF可提高手指端创伤后皮肤缺损修复患者一期愈合率,降低植皮手术率,缩短修复部位愈合时间,术后瘢痕较轻,值得临床推荐。
Objective To investigate the application efect of double-layer artificial dermis combined with topical application of recombinant human basic fibroblast growth factor(rh-bFGF)in the repair of skin defects at the tips of hands.Methods Seventy cases(96 fingers)of patients with finger-end trauma with skin defect repair admitted from August 2018 to December 2023 were selected and divided into two groups according to whether recombinant human fibroblast growth factor was used or not.In the control group,31 patients(40 fingers)were treated with double-layer artificial dermis to cover the trauma after thorough debridement,and in the observation group,39 patients(56 fingers)were treated with recombinant human fibroblast growth factor on the basis of double-layer artificial dermis to cover the trauma.Phase I healing,healing time,Vancouver Scar Scale(VSS)score and hand function score were recorded in both groups.Results The one-stage healing rate of the observation group was 87.18%,which was higher than 64.52%of the control group(P<0.05).Eleven patients in the control group and five patients in the observation group had a small amount of traumatic residue after removing the artificial dermal silicone membrane,and all of them underwent implantation surgery,and the survival rate of implantation area in both groups was 100%.The infection rate of the two groups(6.45%in the control group and 0.00%in the observation group)was compared,and the diference was not statistically significant(P>0.05).Both groups were followed up for 6 months,and the healing time of the observation group was(31.36±3.15)days,which was shorter than the healing time of the control group(38.94±3.87)days(P<0.05).At 6 months after operation,the VSS scores of the observation group were lower than those of the control group(P<0.05).There was no significant diference in the scores of each dimension of hand function between the two groups(P>0.05).Conclusion The combined use of double-layered artificial dermis and topical rh-bFGF can improve the one-stage healing rate in patients with fingertip trauma-induced skin defects,reduce the need for skin grafting surgery,shorten the healing time at the repair site,result in lighter postoperative scars,and is clinically recommended.
作者
黄静
林木良
王婷婷
胡小峰
郑晓飞
冷楠楠
HUANG Jing;LIN Muliang;WANG Tingting;HU Xiaofeng;ZHENG Xiaofei;LENG Nannan(Department of Orthopedics(Hand and Foot Surgery Ward),Qinhuai Medical Area,Eastern Theater General Hospital,Nanjing 210000,Jiangsu,China)
出处
《中国美容医学》
2026年第1期58-62,共5页
Chinese Journal of Aesthetic Medicine
