应用人工真皮和自体皮移植修复难愈性创面的效果

Application Effect of Artificial Dermis and Autologous Skin Grafting in Repairing the Refractory Wound

目的探讨难愈性创面采用人工真皮联合自体皮移植修复的效果。方法选取22例于2014年5月—2015年5月期间该院接收的慢性难愈性创面患者,根据修复难度、创面性质分为慢性溃疡组(n=10)和骨外露组(n=12),均采用人工真皮联合自体皮移植修复,观察修复效果。结果 22例患者的26处创面中,经人工真皮移植后,有20例,创面23处愈合达优良(88.5%),中2例,创面3处,2周后对成活的20例患者进行自体薄层皮片移植,术后所植皮片均全部成活,成活率100.0%;慢性溃疡组12处创面中,1处中,4处良,7处优,骨外露组14处创面12处为优;在不同时间点取创面分泌物行细菌学培养,相较于入院时的创面细菌情况,人工真皮植入14 d后创面细菌得到有效控制。结论难愈性创面采用人工真皮与自体皮移植联合修复,方法简便,且创面成活率高,供皮区损失轻微,具有推广价值。

Objective To discuss the effect of artificial dermis and autologous skin grafting in repairing the refractory wound. Methods 22 cases of patients with chronic refractory wound admitted and treated in our hospital from May 2014 to May 2015 were selected and divided into the chronic ulcer group（n=10） and bone exposure group（u=12） according to the repair difficulty and wound nature, and both groups adopted the artificial dermis and autologous skin grafting, and the repair effect was observed. Results After the artificial dermis grafting, the excellent and good rate of 23 wounds in 20 cases was 88.5%, 2 cases were middle, including 3 wounds, after 2 weeks, 20 cases of patients were. given the autologous sheet skin autograft transplantation, and the survival rate was 100.0%, in the 12 wounds in the chronic ulcer group, 1 was middle and 4 cases were good and 7 cases were excellent, in the 14 wounds in the bone exposure group, there were 12 excellent wounds, and the wound bacterial was effectively controlled after 14 d of artificial dermis grafting. Conclusion The method of artificial dermis and autologous skin grafting in repairing the refractory wound is simple with high wound survival rate, and the damage of the donor area is slight, which is worth promotion.