人工真皮修复急性创伤后足背皮肤软组织缺损14例

Repair of acute traumatic soft tissue defects of foot with artificial dermis in 14 cases

背景:人工真皮具有硅胶膜和胶原海绵双层结构,是最早开发和应用于临床的组织工程化皮肤替代物,主要应用于皮肤软组织缺损修复。目的:评价人工真皮在足背严重皮肤软组织缺损中的应用。方法:选择北京积水潭医院烧伤科于2009-06/2010-12收治的14例急性外伤后足背严重皮肤软组织缺损患者,均有肌腱或骨外露。所有患者经清创后,以人工真皮移植,待人工真皮成活后以自体断层皮片移植,观察人工真皮和自体皮的成活情况。结果与结论:所有植皮成活,创面愈合良好,供区未见明显瘢痕增生。提示人工真皮联合自体断层皮片移植可以有效修复足背严重皮肤缺损创面,减少供区损伤。

BACKGROUND： Artificial dermis has a bilayer structure of collagen sponge and silicone layer, which has been developed and successfully applied in clinics. It is commonly used for the repair of defects of skin and soft tissue. OBJECTIVE： To study and appraise the application of artificial dermis in repairing severe defect of skin and soft tissue of foot. METHODS： A total of 14 patients were admitted at the Department of Burn and Plastic Surgery, Beijing Jishuitan Hospital from June 2009 to December 2010, and all cases had skin and soft tissue defects with tendon or bone exposure due to acute trauma. All the patients were performed debridement and artificial dermis transplantation followed by autologous split-thickness skin graft. The survival of artificial dermis and split-thickness skin was observed. RESULTS AND CONCLUSION： All cases had good coverage of wounds and recheck outcome showed skin graft healing was excellent and donor sites had no obvious skin scar. The results demonstrated that artificial dermis graft in combination with autologous split-thickness skin graft is effective to repair severe defects of skin and soft tissue of foot with a small injury of donor site.