人工真皮联合自体薄层皮片移植修复下肢创伤骨外露创面

Artificial dermis combined with autologous thin skin transplantation for repair of lower limb traumatic wound with bone exposure

目的总结及分析人工真皮联合自体薄层皮片移植修复骨外露创面的临床效果。方法回顾性分析武汉大学同仁医院暨武汉市第三医院烧伤科自2010年6月至2013年6月收治的11例下肢创伤后骨外露患者的临床资料,男10例,女1例,年龄为23~76岁,所有患者均行一期扩创及人工真皮种植,二期行自体薄层皮片移植修复,通过评估创面恢复情况及取皮创口恢复情况综合评价治疗效果。结果 11例患者供皮区取皮后表皮再次形成时间为（15.5±2.5）d,一期手术后行二期植皮时间为（18.5±2.2）d;创面移植皮片均完好存活,愈合良好,外观平整,皮肤颜色略深于正常皮肤;2例患者供皮区域出现极轻度瘢痕,1例轻度瘢痕,余8例无明显瘢痕形成,整体效果满意。结论人工真皮联合自体薄层皮片移植是治疗骨外露的有效方法。

Objective To summarize and analyze the clinical effect of artificial dermis combined with autologous thin skin transplantation for repair of lower limb traumatic wound with bone exposure. Methods Elven lower limb traumatic wound with bone exposure patients were analyzed retrospectively in Department of Burns, Wuhan Third Hospital ＆ Tongren Hospital of Wuhan University from June 2010 to June 2013. Of the 11 patients, 10 were male, 1 was female, aged from 23 to 76 years,were treated with expanson of debridement and artificial dermis in the first stage and autologous thin split thickness skin grafts in the second stage. Treatment effect was evaluated through the recovery condition of traumatic wound and skin transplantation wound. Results Skin regeneration time after skin donor site of 11 patients were（15. 5±2. 5）d, the time of second stage skin grafting operation after first stage operation were （18. 5±2. 2）d. Eleven patients with skin graft were intact, good healing, smooth appearance, skin color was slightly deeper than normal skin. There were 2 patients with very slight scar, 1 patients with mild scar and 8 patients without obvious scar formation. Patients were satisfied with the overall effect. Conclusion Artificial dermis combined with autologous thin skin transplantation is effective to repair lower limb traumatic wound with bone exposure.