自体微粒皮培植修复皮肤慢性溃疡创面的临床分析

Clinical Report of Repair of Chronic Skin Ulcers with Autografting Microparticle Skin.

目的:探讨自体微粒皮培植表皮化在皮肤慢性溃疡创面修复治疗中的应用。方法:先利用皮肤外科技术清除创面坏死组织后,利用湿润烧伤膏培养肉芽,然后按溃疡创面:取皮面积=20～30:1的比例取韧厚皮剪成微粒皮粒后种植于肉芽中,再用湿润烧伤膏培植微粒皮直至表皮化修复创面。结果:2005年9月～2007年9月我们用微粒皮种植术治疗31例皮肤慢性溃疡患者获得满意效果。结论:微粒皮种植术结合湿润烧伤膏治疗皮肤慢性溃疡,手术操作简单,术后供皮区愈合好,溃疡区修复后皮肤柔软、瘢痕少、功能影响小;由于手术取皮面积远远小于创面,微粒皮直接种植于创面肉芽内,术后对创面关节活动要求相对低,所以患者依从性好。本法缺点是部分病例种植的微粒皮成活率较低,须多次种植,修复时间可能较长。

Objective： To explore the epidemic repair of chronic skin ulcers treating with autografting microparticle skin. Method： After necrotic tissue removed at the wound with surgery method and granulation tissue cultured with ME- BO, microparticle skin tablet prapared with split - thickness skin according to the proportion of 20 - 30 ： 1 （ Ulcer area ： skin area） and then the skin tablets were cultivated at granulation with MEBO till epidemic repair completed. Result： All 31 cases of chronic ulcer patients collected from Sep. 2005 to Sep. 2007 were treated with microparticle skin tablets culture and satisfactory effect was obtained. Conclusion： Treating chronic ulcers with microparticle skin tablets autografting cultured by MEBO has advantages, such as simple operation, good repair effect for donate site wound; and soft skin, less scar formation and better joint function obtained at healed ulcer wound site. Because the area of donor site was far less than that of ulcer wound and microparticle skin tablets were planted into granulation directly, little requirement for the joint function was required after surgery, so it is more acceptable by the patient. But, there are some disadvantages including lower survival rate of microparticle skingrafting. For some patients, multiple grafting and longer repair time are required sometime.