异体脱细胞真皮在软组织缺损修复中的应用

Application of the allogenic acellular dermal matrix in the repair of the surface tissue defects

目的：评估应用异体脱细胞真皮（allo-ADM）修复体表软组织缺损的临床效果。方法：12例面部凹陷畸形，用allo-ADM填充修复；23例功能部位瘢痕挛缩畸形和5例胸部瘢痕疙瘩合并溃疡，松解、切除瘢痕后用allo—ADM与自体刃厚皮复合移植修复。结果：12例面部凹陷畸形填充术后Ⅰ期愈合，随访6个月～1年，除2例因填充量不足而再次手术外，均未见明显排异、吸收等并发症，局部柔软，外形良好。28例复合皮移植术后，除1例因感染致部分坏死（40％）外，其余成活率在90％以上；随访1年，外观与功能均近似自体中厚或全厚皮移植效果。结论：allo-ADM是填充、修复体表软组织缺损较理想的材料，亦为瘢痕疙瘩的治疗提供了新的方法。

Objective To evaluate the clinical effects of AIIogeneic acellular dermal matrite （alIo-ADM） in the repair of the surface tissue defects. Mathods 12 patients with facial depression were treated by using acellular dermal matrix for soft-tissue augmentation. 23 patients with scar contraction in articular or functional sites and 5 patients with keloids complicated with ulcers in the anterior breast were treated by complex grafts （alIo-ADM plus autologous epiderm skin） after scar release and excision. Result After a 6-20months following -up, Except 2 patients were refilled because of the insufficiency of the primary filler, All 12 patients with facial depression were primary healing and had excellent appearance, no serious complication such as rejection, inflammatory response or absorbtion were encountered; in 28 patients with scar contraction, which were followed up 1 year, except partial necrosis of the grafted skin appeared on 1 patient because of the infection （40%）, the survival rate of graft skin reached 90% in other patients, and the color, luster and function were similar to that of intermediate split thickness skin graft or full thickness skin graft. Conclusion The alIo-ADM is not only an ideal material for soft tissue filling but also presents a new choice for treatment of keloid.