BACKGROUND The recovery time of hand wounds is long,which can easily result in chronic and refractory wounds,making the wounds unable to be properly repaired.The treatment cycle is long,the cost is high,and it is pron...BACKGROUND The recovery time of hand wounds is long,which can easily result in chronic and refractory wounds,making the wounds unable to be properly repaired.The treatment cycle is long,the cost is high,and it is prone to recurrence and disability.Double layer artificial dermis combined with autologous skin transplantation has been used to repair hypertrophic scars,deep burn wounds,exposed bone and tendon wounds,and post tumor wounds.AIM To investigate the therapeutic efficacy of autologous skin graft transplantation in conjunction with double-layer artificial dermis in treating finger skin wounds that are chronically refractory and soft tissue defects that expose bone and tendon.METHODS Sixty-eight chronic refractory patients with finger skin and soft tissue defects accompanied by bone and tendon exposure who were admitted from July 2021 to June 2022 were included in this study.The observation group was treated with double layer artificial dermis combined with autologous skin graft transplantation(n=49),while the control group was treated with pedicle skin flap transplantation(n=17).The treatment status of the two groups of patients was compared,including the time between surgeries and hospital stay.The survival rate of skin grafts/flaps and postoperative wound infections were evaluated using the Vancouver Scar Scale(VSS)for scar scoring at 6 mo after surgery,as well as the sensory injury grading method and two-point resolution test to assess the recovery of skin sensation at 6 mo.The satisfaction of the two groups of patients was also compared.RESULTS Wound healing time in the observation group was significantly longer than that in the control group(P<0.05,27.92±3.25 d vs 19.68±6.91 d);there was no significant difference in the survival rate of skin grafts/flaps between the two patient groups(P>0.05,95.1±5.0 vs 96.3±5.6).The interval between two surgeries(20.0±4.3 d)and hospital stay(21.0±10.1 d)in the observation group were both significantly shorter than those in the control group(27.5±9.3 d)and(28.4±17.7 d),respectively(P<0.05).In comparison to postoperative infection(23.5%)and subcutaneous hematoma(11.8%)in the control group,these were considerably lower at(10.2%)and(6.1%)in the observation group.When comparing the two patient groups at six months post-surgery,the excellent and good rate of sensory recovery(91.8%)was significantly higher in the observation group than in the control group(76.5%)(P<0.05).There was also no statistically significant difference in two point resolution(P>0.05).The VSS score in the observation group(2.91±1.36)was significantly lower than that in the control group(5.96±1.51),and group satisfaction was significantly higher(P<0.05,90.1±6.3 vs 76.3±5.2).CONCLUSION The combination of artificial dermis and autologous skin grafting for the treatment of hand tendon exposure wounds has a satisfactory therapeutic effect.It is a safe,effective,and easy to operate treatment method,which is worthy of clinical promotion.展开更多
In the treatment of extensive burns, cultured epithelial autograph (CEA) became available commercially in Japan from 2009. Based on the 6 years multicenter surveillance data on using CEA for extensive burns, it is rep...In the treatment of extensive burns, cultured epithelial autograph (CEA) became available commercially in Japan from 2009. Based on the 6 years multicenter surveillance data on using CEA for extensive burns, it is reported that using 6:1 split thickness skin graft together with CEA is successful after wound bed preparation for extensive deep dermal burn or patients with deep burn [1].展开更多
Background: Bilayer artificial dermis promotes wound healing and offers a treatment option for chronic wounds. Aim: Examine the clinical efficacy of bilayer artificial dermis combined with Vacuum Sealing Drainage (VSD...Background: Bilayer artificial dermis promotes wound healing and offers a treatment option for chronic wounds. Aim: Examine the clinical efficacy of bilayer artificial dermis combined with Vacuum Sealing Drainage (VSD) technology in the treatment of chronic wounds. Method: From June 2021 to December 2023, our hospital treated 24 patients with chronic skin tissue wounds on their limbs using a novel tissue engineering product, the bilayer artificial dermis, in combination with VSD technology to repair the wounds. The bilayer artificial dermis protects subcutaneous tissue, blood vessels, nerves, muscles, and tendons, and also promotes the growth of granulation tissue and blood vessels to aid in wound healing when used in conjunction with VSD technology for wound dressing changes in chronic wounds. Results: In this study, 24 cases of chronic wounds with exposed bone or tendon larger than 1.0 cm2 were treated with a bilayer artificial skin combined with VSD dressing after wound debridement. The wounds were not suitable for immediate skin grafting. At 2 - 3 weeks post-treatment, good granulation tissue growth was observed. Subsequent procedures included thick skin grafting or wound dressing changes until complete wound healing. Patients were followed up on average for 3 months (range: 1 - 12 months) post-surgery. Comparative analysis of the appearance, function, skin color, elasticity, and sensation of the healed chronic wounds revealed superior outcomes compared to traditional skin fl repairs, resulting in significantly higher satisfaction levels among patients and their families. Conclusion: The application of bilayer artificial dermis combined with VSD technology for the repair of chronic wounds proves to be a viable method, yielding satisfactory therapeutic effects compared to traditional skin flap procedures.展开更多
Objective: To explore the effect of artificial dermis combined with rhGM-CSF(Jinfuning) on healing of soft tissue defect of finger ventral skin and the influence of bacterial detection rate. Methods: Totally 110 patie...Objective: To explore the effect of artificial dermis combined with rhGM-CSF(Jinfuning) on healing of soft tissue defect of finger ventral skin and the influence of bacterial detection rate. Methods: Totally 110 patients with finger injury admitted to the rehabilitation department of our department from January 2017 to June 2018 were collected and divided into control group and observation group according to the random number table method with 55 cases in each group. The control group received direct artificial derma lrepairing after thorough debridement, while the observation group received recombinant gm-csf gel coating on the wound surface before artificial dermal repairing, Wound healing, wound inflammation, bacterial detection rate, inflammatory factor expression, follow-up and adverse reactions were compared between the two groups. Results: The wound healing rate of the observation group at 7, 14, 21 and 28 days after treatment was significantly higher than that of the control group (t= 11.211, P =0.000).( T = 14.895, P =0.000;T = 25.346, P=0.000;T =8.247, P=0.000). The wound healing time of the observation group was (19.7±2.3) d, and that of the control group was (27.4±3.3) d. The average wound healing time of the observation group was significantly shorter than that of the control group, and the difference was statistically significant (t=14.197, P= 0.000). Observation group wound inflammation at each time point score was significantly lower than the control group, the group rooms, time points, ·point interaction effect between the comparison, the differences were statistically significant (P <0.05), the observation group wound bacteria detection rate of 7.27% (4 cases) : the control bacteria detection rate was 21.81% (12 cases), difference was statistically significant (chi-square = 4.68, P= 0.0305), the observation group of bacteria detection rate was significantly lower than the control group;The bacteria detected in the two groups were mainly e. coli, tetanus bacillus and fungi. There was no significant difference in the indicators between the two groups before treatment, and the values of inflammatory cytokines il-1 and TNF- IOD in the two groups were significantly decreased after treatment, and the observation group was significantly lower than the control group, with statistically significant differences (P < 0.05). No serious adverse reactions occurred in either group during the treatment. Conclusion: the application of artificial dermals combined with jinfuning can promote wound healing of skin and soft tissue defect of finger abdomen, effectively inhibit bacterial infection of wound surface, reduce inflammation and infection,reducing bacterial detection rate.展开更多
Background Diabetic wound is one of the most serious complications of diabetes mellitus. There are no significantly effective therapies for chronic non-healing diabetes ulcer so far. This study aimed to explore the fe...Background Diabetic wound is one of the most serious complications of diabetes mellitus. There are no significantly effective therapies for chronic non-healing diabetes ulcer so far. This study aimed to explore the feasibility of healing impaired wound using artificial dermis constructed with human adipose derived stem cells （ASCs） and poly（L-glutamic acid）/chitosan （PLGA/CS） scaffold in streptozotocin-induced diabetic mice. Methods ASCs were isolated from fresh human lipoaspirates and expanded ex vivo for three passages, and then cells were seeded onto PLGNCS scaffold to form artificial dermis. Expression of VEGF and TGFI31 by ASCs presented in artificial dermis was determined. The artificial dermis was transplanted to treat the 20 mm ~ 20 mm full-thickness cutaneous wound created on the back of diabetic mice. Wound treated with scaffold alone and without treatment, and wound in normal non-diabetic mice served as control. Results Cells growing within scaffold showed great proliferation potential, depositing abundant collagen matrix. Meanwhile, expression of VEGF and TGF-131 by seeded ASCs maintained at a consistent high level. After treated with ASC based artificial dermis, diabetic wounds exhibited significantly higher healing rate compared with wounds treated with scaffold alone or without treatment. Histological examination also demonstrated an improvement in cutaneous restoration with matrix deposition and organization. Further quantitative analysis showed that there was a significant increase in dermis thickness and collagen content on artificial dermis treated wounds. Conclusion ASC/PLGA artificial dermis can effectively accelerate diabetic wound healing by promoting angiogenic growth factors and dermal collagen synthesis.展开更多
基金Clinical Study of Artificial Dermis Combined with Skin Flap Replacement Flap in Limb Wound Repair,No.WX21C27.
文摘BACKGROUND The recovery time of hand wounds is long,which can easily result in chronic and refractory wounds,making the wounds unable to be properly repaired.The treatment cycle is long,the cost is high,and it is prone to recurrence and disability.Double layer artificial dermis combined with autologous skin transplantation has been used to repair hypertrophic scars,deep burn wounds,exposed bone and tendon wounds,and post tumor wounds.AIM To investigate the therapeutic efficacy of autologous skin graft transplantation in conjunction with double-layer artificial dermis in treating finger skin wounds that are chronically refractory and soft tissue defects that expose bone and tendon.METHODS Sixty-eight chronic refractory patients with finger skin and soft tissue defects accompanied by bone and tendon exposure who were admitted from July 2021 to June 2022 were included in this study.The observation group was treated with double layer artificial dermis combined with autologous skin graft transplantation(n=49),while the control group was treated with pedicle skin flap transplantation(n=17).The treatment status of the two groups of patients was compared,including the time between surgeries and hospital stay.The survival rate of skin grafts/flaps and postoperative wound infections were evaluated using the Vancouver Scar Scale(VSS)for scar scoring at 6 mo after surgery,as well as the sensory injury grading method and two-point resolution test to assess the recovery of skin sensation at 6 mo.The satisfaction of the two groups of patients was also compared.RESULTS Wound healing time in the observation group was significantly longer than that in the control group(P<0.05,27.92±3.25 d vs 19.68±6.91 d);there was no significant difference in the survival rate of skin grafts/flaps between the two patient groups(P>0.05,95.1±5.0 vs 96.3±5.6).The interval between two surgeries(20.0±4.3 d)and hospital stay(21.0±10.1 d)in the observation group were both significantly shorter than those in the control group(27.5±9.3 d)and(28.4±17.7 d),respectively(P<0.05).In comparison to postoperative infection(23.5%)and subcutaneous hematoma(11.8%)in the control group,these were considerably lower at(10.2%)and(6.1%)in the observation group.When comparing the two patient groups at six months post-surgery,the excellent and good rate of sensory recovery(91.8%)was significantly higher in the observation group than in the control group(76.5%)(P<0.05).There was also no statistically significant difference in two point resolution(P>0.05).The VSS score in the observation group(2.91±1.36)was significantly lower than that in the control group(5.96±1.51),and group satisfaction was significantly higher(P<0.05,90.1±6.3 vs 76.3±5.2).CONCLUSION The combination of artificial dermis and autologous skin grafting for the treatment of hand tendon exposure wounds has a satisfactory therapeutic effect.It is a safe,effective,and easy to operate treatment method,which is worthy of clinical promotion.
文摘In the treatment of extensive burns, cultured epithelial autograph (CEA) became available commercially in Japan from 2009. Based on the 6 years multicenter surveillance data on using CEA for extensive burns, it is reported that using 6:1 split thickness skin graft together with CEA is successful after wound bed preparation for extensive deep dermal burn or patients with deep burn [1].
文摘Background: Bilayer artificial dermis promotes wound healing and offers a treatment option for chronic wounds. Aim: Examine the clinical efficacy of bilayer artificial dermis combined with Vacuum Sealing Drainage (VSD) technology in the treatment of chronic wounds. Method: From June 2021 to December 2023, our hospital treated 24 patients with chronic skin tissue wounds on their limbs using a novel tissue engineering product, the bilayer artificial dermis, in combination with VSD technology to repair the wounds. The bilayer artificial dermis protects subcutaneous tissue, blood vessels, nerves, muscles, and tendons, and also promotes the growth of granulation tissue and blood vessels to aid in wound healing when used in conjunction with VSD technology for wound dressing changes in chronic wounds. Results: In this study, 24 cases of chronic wounds with exposed bone or tendon larger than 1.0 cm2 were treated with a bilayer artificial skin combined with VSD dressing after wound debridement. The wounds were not suitable for immediate skin grafting. At 2 - 3 weeks post-treatment, good granulation tissue growth was observed. Subsequent procedures included thick skin grafting or wound dressing changes until complete wound healing. Patients were followed up on average for 3 months (range: 1 - 12 months) post-surgery. Comparative analysis of the appearance, function, skin color, elasticity, and sensation of the healed chronic wounds revealed superior outcomes compared to traditional skin fl repairs, resulting in significantly higher satisfaction levels among patients and their families. Conclusion: The application of bilayer artificial dermis combined with VSD technology for the repair of chronic wounds proves to be a viable method, yielding satisfactory therapeutic effects compared to traditional skin flap procedures.
文摘Objective: To explore the effect of artificial dermis combined with rhGM-CSF(Jinfuning) on healing of soft tissue defect of finger ventral skin and the influence of bacterial detection rate. Methods: Totally 110 patients with finger injury admitted to the rehabilitation department of our department from January 2017 to June 2018 were collected and divided into control group and observation group according to the random number table method with 55 cases in each group. The control group received direct artificial derma lrepairing after thorough debridement, while the observation group received recombinant gm-csf gel coating on the wound surface before artificial dermal repairing, Wound healing, wound inflammation, bacterial detection rate, inflammatory factor expression, follow-up and adverse reactions were compared between the two groups. Results: The wound healing rate of the observation group at 7, 14, 21 and 28 days after treatment was significantly higher than that of the control group (t= 11.211, P =0.000).( T = 14.895, P =0.000;T = 25.346, P=0.000;T =8.247, P=0.000). The wound healing time of the observation group was (19.7±2.3) d, and that of the control group was (27.4±3.3) d. The average wound healing time of the observation group was significantly shorter than that of the control group, and the difference was statistically significant (t=14.197, P= 0.000). Observation group wound inflammation at each time point score was significantly lower than the control group, the group rooms, time points, ·point interaction effect between the comparison, the differences were statistically significant (P <0.05), the observation group wound bacteria detection rate of 7.27% (4 cases) : the control bacteria detection rate was 21.81% (12 cases), difference was statistically significant (chi-square = 4.68, P= 0.0305), the observation group of bacteria detection rate was significantly lower than the control group;The bacteria detected in the two groups were mainly e. coli, tetanus bacillus and fungi. There was no significant difference in the indicators between the two groups before treatment, and the values of inflammatory cytokines il-1 and TNF- IOD in the two groups were significantly decreased after treatment, and the observation group was significantly lower than the control group, with statistically significant differences (P < 0.05). No serious adverse reactions occurred in either group during the treatment. Conclusion: the application of artificial dermals combined with jinfuning can promote wound healing of skin and soft tissue defect of finger abdomen, effectively inhibit bacterial infection of wound surface, reduce inflammation and infection,reducing bacterial detection rate.
文摘Background Diabetic wound is one of the most serious complications of diabetes mellitus. There are no significantly effective therapies for chronic non-healing diabetes ulcer so far. This study aimed to explore the feasibility of healing impaired wound using artificial dermis constructed with human adipose derived stem cells （ASCs） and poly（L-glutamic acid）/chitosan （PLGA/CS） scaffold in streptozotocin-induced diabetic mice. Methods ASCs were isolated from fresh human lipoaspirates and expanded ex vivo for three passages, and then cells were seeded onto PLGNCS scaffold to form artificial dermis. Expression of VEGF and TGFI31 by ASCs presented in artificial dermis was determined. The artificial dermis was transplanted to treat the 20 mm ~ 20 mm full-thickness cutaneous wound created on the back of diabetic mice. Wound treated with scaffold alone and without treatment, and wound in normal non-diabetic mice served as control. Results Cells growing within scaffold showed great proliferation potential, depositing abundant collagen matrix. Meanwhile, expression of VEGF and TGF-131 by seeded ASCs maintained at a consistent high level. After treated with ASC based artificial dermis, diabetic wounds exhibited significantly higher healing rate compared with wounds treated with scaffold alone or without treatment. Histological examination also demonstrated an improvement in cutaneous restoration with matrix deposition and organization. Further quantitative analysis showed that there was a significant increase in dermis thickness and collagen content on artificial dermis treated wounds. Conclusion ASC/PLGA artificial dermis can effectively accelerate diabetic wound healing by promoting angiogenic growth factors and dermal collagen synthesis.
