异体脱细胞真皮基质联合自体皮肤移植修复颅骨缺损钛网片外露创面

Effects of heterologous acellular dermal matrix combined with autologous skin grafts on the residual wounds with titanium mesh in skull defects

目的：探讨采用异体脱细胞真皮基质（ADM）联合自体皮肤移植（ASG）修复暴露钛网残余创面的方法。方法：10例颅骨缺损钛网片残余创面患者采用I期异体ADM联合I期ASG手术,观察创面愈合情况。结果：术后10例患者ADM和ASG均存活,创面I型切口甲级愈合。平均手术时间为30~45 min,平均出血量为30~50 mL。随访3个月后观察,术区移植皮肤弹性良好,无破损。结论：异体ADM联合ASG修复暴露钛网残余创面的新方法在一定程度可以避免其他手术如局部穿支皮瓣及游离皮瓣手术的需要更多的工作时间、特殊设备和足够的训练等复杂的术前准备要求。

Objective： To explore the therapeutic means of heterologous acellular dermal matrix（ADM） combined with autologous skin graft（ASG） to repair the residual skull defective wounds with titanium mesh exposed. Methods： Heterologous acellular dermal matrix（phase I） combined with autologous skin graft（phase II） transplantation operation was used in 10 patients of titanium mesh skull defect with exposed residual wound. The wound heal situation was observed. Results： ADM and ASG were all alive in 10 patients. Healing of type II incision on the wound was in grade I. The average operation duration was 30-45 min, while the average volume of blood loss was 30-50 mL. After follow-up observation for three months, skin elasticity at the surgical transplantation area was good without damage. Conclusion： The new therapeutic method for repairing the residual wound with exposure titanium mesh by means of ADM combined with ASG transplantation can avoid to some extent requiring more working time than other operations, such as regional perforating branch fl ap and free fl ap transplantation, and needn＇t special equipment, adequate train and the complex preoperative preparation.