人工真皮修复手指末节皮肤软组织缺损的临床疗效

Clinical efficacy of artificial dermis in repairing skin and soft tissue defect of distal finger

目的 探讨人工真皮修复手指末节皮肤软组织缺损的应用和临床疗效。方法 自2022年3月至2023年3月,南通大学附属江阴医院手外科采用人工真皮修复25例(27指)手指末节皮肤软组织缺损患者,创面面积0.5 cm×1.0 cm~1.5 cm×2.5 cm。清创后人工真皮覆盖创面,术后定期换药,术后4周拆除人工真皮。结果 25例(27指)患者人工真皮修复创面均一期愈合。所有患者获随访6~18个月,指端质地柔软、外形美观;无明显瘢痕挛缩、无色素沉着;手指活动功能良好。新生皮肤感觉恢复良好,无冷敏感及刺痛,两点辨别觉为3~8 mm。远指间关节活动正常,对指功能良好。按中华医学会手外科学会上肢部分功能评定试用标准评定,优良率为100%。结论 人工真皮修复手指末节皮肤软组织缺损手术操作安全简单,无供区损伤,修复后手指饱满,质地柔软,活动及感觉功能恢复良好,是一种安全可靠的治疗方法。

Objective To explore the application and clinical effect of artificial dermis in repairing skin and soft tissue defects at the end of fingers.Methods From March 2022 to March 2023,25 patients(27 fingers)with skin and soft tissue defects of distal fingers were repaired with artificial dermis in the Department of Hand Surgery of Jiangyin Hospital affiliated to Nantong University.The wound area was 0.5 cm×1.0 cm~1.5 cm×2.5 cm.After debridement,the artificial dermis covered the wound,changed dressing regularly after opera-tion,and the artificial skin was removed in 4 weeks.Results The wounds of 25 cases(27 fingers)repaired with artificial skin healed in one stage.During the follow-up of 6 to 18 months,the fingertips had soft texture,beautiful appearance,no obvious scar contracture,no pig-mentation and good finger movement function.The sensation of the flap recovered well and there was no cold sensitivity and tingling.The two-point discrimination was 3~8 mm.The activity of the distal interphalangeal joint is normal and the function of the opposite finger is good.According to the trial standard of upper limb function evaluation of hand surgery Association of Chinese Medical Association,the ex-cellent and good rate is 100%.Conclusion The operation of repairing skin and soft tissue defect of distal finger with artificial dermis is safe and simple,there is no donor site injury,the finger is full,the texture is soft,and the activity and sensory function recover well.It is a safe and reliable treatment method.