人工真皮自行上皮化修复手部创面43例

Application of Artificial Dermis Self-Epithelialisation for Repair of Hand Wounds:43 Cases Report

目的:探讨应用兰度双层人工真皮自行上皮化修复手部创面的疗效。方法:选取急性损伤引起的手部小面积创面患者43例,通过使用人工真皮移植自行上皮化的方法修复创面,末次随访时使用温哥华瘢痕量表(Vancouver Scar Scale,VSS)评分、静态两点辨别觉(Static 2-Point Discrimination,S2PD)和密歇根手部功能量表(Michigan Hand Outcomes Questionnaire,MHQ)评分进行评估。结果:43例患者创面全部愈合良好,合并甲床损伤者有3例轻微钩甲畸形。末次随访时VSS评分、S2PD和MHQ评分分别为(4.0±0.9)分、(4.2±1.0)mm及(82.0±7.7)分。新生软组织柔韧,瘢痕增生少,颜色接近正常皮肤。结论:应用双层人工真皮自行上皮化修复手部小面积创面,临床操作简便,可避免供区损伤,且患者满意度较高,可作为人工真皮两步法移植、游离皮片移植或皮瓣修复术的一种可靠代替修复手段。

Objective:To explore the efficacy of self-epithelialization of Lando double-layer artificial dermis in repairing hand wounds.Methods:43 patients with small-area hand wounds caused by acute injuries were selected and the wounds were repaired by using artificial dermal grafts to self-epithelialize.They evaluated by Vancouver Scar Scale(VSS),Static 2-Point Discrimination(S2PD)and Michigan Hand Outcomes Questionnaire(MHQ)at the last follow-up.Results:All the wounds of 43 patients healed well.The scores of VSS,S2PD and MHQ are(4.0±0.9)points,(4.2±1.0)mm,and(82.0±7.7)points respectively at the last follow-up.The new soft tissue is flexible,less scar hyperplasia,and the color is close to normal skin.Conclusion:The application of double-layer artificial dermis to repair small-area wounds is easy to operate clinically,can avoid damage to the donor site,and has high patient satisfaction.It can be used as a reliable alterna-tive repair method for One-stage wound healing for free skin grafting or skin flap repair.