新型国产双层人工真皮移植修复手足部肌腱及骨外露创面效果分析

Analysis on the Clinical Effect of New-developed Domestic Double-layer Artificial Dermal Graft in the Restoration of Tendon and Bone Exposure Wounds in Hand and Foot

目的探讨新型国产双层人工真皮移植修复手足部肌腱及骨外露创面的临床疗效。方法回顾性分析2017年1月至12月周口淮海医院收治的符合纳入标准的82例手足部肌腱及骨外露患者的临床资料,按照治疗方法不同将采用新型国产双层人工真皮+自体刃厚皮片移植治疗的42例患者设为观察组,将采用皮能快愈敷料+自体刃厚皮片移植治疗的40例患者设为对照组,对比两组患者的植皮次数、移植间隔时间、温哥华瘢痕量表(Vancouver scar scale,VSS)评分、皮片成活率及皮片破溃率等。结果观察组患者的植皮次数为(1.34±0.31)次、移植间隔时间为(18.50±4.39)d、VSS评分为(4.76±1.98)分、皮片成活率为92.86%、皮片破溃率为2.38%,对照组患者的植皮次数为(1.25±0.34)次、移植间隔时间为(13.14±3.52)d、VSS评分为(5.04±2.14)分、皮片成活率为100%、皮片破溃率为5.00%。两组患者移植间隔时间对比,P<0.01,差异具有统计学意义;植皮次数、VSS评分、皮片成活率及皮片破溃率对比,P均>0.05,差异无统计学意义。结论在手足部肌腱及骨外露创面的治疗中,新型国产双层人工真皮可取得与皮能快愈敷料同等的疗效,但却存在移植间隔时间较长的弊端。

Objective To investigate the clinical effect of new-developed domestic double-layer artificial dermal graft in the restoration of tendon and bone exposure wounds in hand and foot.Methods The clinical data of 82 patients with tendon and bone exposure wounds in hand and foot,who admitted into Zhoukou Huaihai Hospital during January 2017 and December 2017 and met the inclusion criteria,were retrospectively analyzed.The 82 patients were divided into an observation group of 42 patients with the treatment of new-developed domestic double-layer artificial dermal graft in combination with autologous split-thickness graft,and a control group of 40 patients with the treatment of PELNAC in combination with autologous split-thickness graft.The number of grafting,grafting interval,Vancouver scar scale(VSS)score,skin flap survival rate and skin flap ulceration rate were compared between the two groups.Results In the observation group,the number of grafting was(1.34±0.31)times,grafting interval was(18.50±4.39)d,VSS score was(4.76±1.98)points,skin flap survival rate was 92.86%and the skin flap ulceration rate was 2.38%,while the corresponding data in the control group were respectively(1.25±0.34)times,(13.14±3.52)d,(5.04±2.14)points,100%and 5.00%.Statistically significant difference was observed when the graft interval was compared between the two groups,P<0.01.However,no statistically significant difference appeared when the number of grafting,VSS score,skin flap survival rate and skin flap ulceration rate were respectively compared between the two groups,all P>0.05.Conclusion In the treatment of tendon and bone exposure wounds in hand and foot,the new-developed domestic double-layer artificial dermis can realize the equivalent clinical effect as PELNAC,but has the drawback of longer grafting interval.