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Lessons Learned from Three Different Acellular Dermal Matrices in Direct-to-Implant Breast Reconstruction
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作者 Claas Spengler Roland Mett +2 位作者 Frank Masberg Peter M. Vogt Tobias R. Mett 《Modern Plastic Surgery》 2021年第1期22-35,共14页
The aim of the study was to show significant differences regarding postoperative complications and outcomes using three different Acellular Dermal Matrices (ADM), namely Epiflex<span style="white-space:nowrap;... The aim of the study was to show significant differences regarding postoperative complications and outcomes using three different Acellular Dermal Matrices (ADM), namely Epiflex<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span>, Strattice<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span> and Braxon<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span>, in immediate implant-based subpectoral breast reconstruction cases. <strong>Background:</strong> The use of Acellular Dermal Matrices for implant-based breast reconstruction cases continues to evolve. There is a wide variety of products which differ significantly in their biological features. It remains unclear if and how these differences manifest in clinical practice. <strong>Methods:</strong> 82 cases of primary breast reconstruction in the Department of Plastic and Aesthetic Surgery of HELIOS Clinics Schwerin, Germany between 2010 and 2018 were analyzed. 25 patients received Strattice<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span> acellular dermal matrix (SADM), 22 cases Epiflex<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span> acellular dermal matrix (EADM) and the remaining 35 cases Braxon<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span> acellular dermal matrix (BADM). The mean follow-up was 1.8 years. Cases were analyzed regarding minor or major complications and rate of capsular contracture grade III or IV (Baker Classification). <strong>Results:</strong> The overall complication rate was 34.1% for all groups (SADM = 40%, EADM = 50%, BADM = 20%, p-value = 0.051). Of all cases, 6 patients underwent implant exchange or secondary autologous reconstruction due to capsular contracture (7.3%). The mean time between revision due to capsular contracture and reconstruction was 35.8 ± 14.4 months. 50% of patients, who developed capsular contracture, received postoperative radiation. Mean hospitalization time was 8.2 ± 3 days (SADM = 8 ± 3.2 days, EADM = 10 ± 2.8 days, BADM = 6 ± 1.3 days). There were no significant differences between all three groups for demographics, overall complication rate or capsular contracture. However, patients receiving Braxon<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span> matrix showed significantly fewer minor complications (p-value = 0.01). Moreover, patients receiving Braxon<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span> ADM showed a significantly lower time of hospitalization (p < 0.001). <strong>Conclusion:</strong> No significant differences regarding the overall complication rate were found between the three groups. Different biological features of ADM showed a weak influence on overall results. However, patients receiving Braxon<span style="white-space:nowrap;"><span style="white-space:nowrap;"><sup>&#174;</sup></span></span> ADM showed significantly lower minor complication rates and hospitalization time. In addition, these matrices showed a trend towards lower capsular contracture rates. The low rate of capsular contracture hints at possible advantages of ADM-use in direct-to-implant cases. 展开更多
关键词 breast reconstruction acellular dermal matrix ADM Direct-to-Implant DTI Immediate breast reconstruction IBR breast Cancer Skin Sparing Mastectomy EPIFLEX Strattice BRAXON
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Reconstruction of the abdominal wall by using a combination of the human acellular dermal matrix implant and an interpositional omentum flap after extensive tumor resection in patients with abdominal wall neoplasm: A preliminary result 被引量:11
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作者 Yan Gu Rui Tang +1 位作者 Ding-Quan Gong Yun-Liang Qian 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第5期752-757,共6页
AIM: To present our trial using a combination of the human acellular dermal matrix (HADM) implant and an interpositional omentum flap to repair giant abdominal wall defects after extensive tumor resection. METHODS... AIM: To present our trial using a combination of the human acellular dermal matrix (HADM) implant and an interpositional omentum flap to repair giant abdominal wall defects after extensive tumor resection. METHODS: Between February and October of 2007, three patients with giant defects of the abdominal wall after extensive tumor resection underwent reconstruction with a combination of HADN and omentum flap. Postoperative morbidities and signs of herniation were monitored. RESULTS: The abdominal wall reconstruction was successful in these three patients, there was no severe morbidity and no signs of herniation in the follow-up period. CONCLUSION: The combination of HADM and omentum flap offers a new, safe and effective alternative to traditional forms in the repair of giant abdominal wall defects. Further analysis of the long-term outcome and more cases are needed to assess the reliability of this technique. 展开更多
关键词 Abdominal wall neoplasm Abdominal wall reconstruction Human acellular dermal matrix Omentum flap
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Application of acellular dermal matrix in breast reconstruction 被引量:1
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作者 QI Yue YOU Wei-tao +1 位作者 LI Dong LI Jian-ning 《Chinese Medical Journal》 SCIE CAS CSCD 2013年第13期2548-2552,共5页
In the past 10 years, acellular dermal matrix (ADM) has .been widely used in various fields of surgery, includingcleft palate repair, abdominal wall repair, tendon repair, hernia repair, facial and eyelid soft tissu... In the past 10 years, acellular dermal matrix (ADM) has .been widely used in various fields of surgery, includingcleft palate repair, abdominal wall repair, tendon repair, hernia repair, facial and eyelid soft tissue augmentation surgery, ulcer repair, and vaginal sling repair, among others.1-3 ADM not only provides initial structural strength and bulk, but also allows relatively rapid vascular growth and serves as a scaffold for "new" tissue formation.4 These properties have led to its application to resolving surgical problems where tissue deficiency remains an issue. Many surgeons have begun to use ADM-assisted breast reconstruction techniques. Compared with ADM, the traditional method of implant-based breast reconstruction is more straightforward but is more prone to postoperative complications. Generally speaking, breast revision surgery procedures are complex, challenging, and unpredictable as the potential for the development of serious complications, such as capsular contracture (CC), must be addressed. CC has plagued plastic surgeons as the most common complication of reconstructive breast surgery for many yearsY The application of ADM addresses these problems, and as a result, its popularity is growing: in the United States 73% of surgeons have some experience in the use of xenogeneic or allogeneic ADM in breast reconstruction.8 Furthermore, the use of ADM in nipple and areola reconstruction can achieve a more natural appearance and avoids complications of other more traditional techniques.~ In cases of breast reconstruction, techniques that incorporate the use of ADM have been used to treat and reduce the incidence of CC, determine the position of the inframammary fold and final breast contour, enhance the use of available mastectomy skin, and increase the thickness of the soft tissue to reduce implant visibility or palpability. These goals can be achieved by replacing or extending the tissue with ADM or using ADM as a supplement. In addition to the advantages afforded by the use of ADM, the safety and efficacy of these techniques have been widely reported.1-1 Tissue expander breast reconstruction consists of three major surgical steps: placement of the expander after mastectomy, exchange of the expander for an implant, and nipple-areola complex reconstruction. This article summarizes the main methods and different aspects of ADM-assisted breast reconstruction. 展开更多
关键词 acellular dermal matrix breast reconstruction nipple reconstruction
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Meshed acellular dermal matrix:technique and application in implant based breast reconstruction
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作者 Dino Zammit Jonathan Kanevsky +1 位作者 Fan-Yi Meng Tassos Dionisopoulos 《Plastic and Aesthetic Research》 2016年第1期254-256,共3页
Alloderm was the first acellular dermal matrix used and remains a popular choice among plastic surgeons.However,while the overall surgical outcome of breast reconstruction using alloderm has been a success,the economi... Alloderm was the first acellular dermal matrix used and remains a popular choice among plastic surgeons.However,while the overall surgical outcome of breast reconstruction using alloderm has been a success,the economic burden on the health care system makes it a subject of frequent re-evaluations in cost-effectiveness.Prompted by the high price of$3,700 USD for a 6 cm×16 cm area,our group proposes the meshing of AlloDerm to decrease the total amount needed for breast reconstruction,while achieving comparable surgical outcomes as using unmeshed alloderm. 展开更多
关键词 ALLODERM acellular dermal matrix breast reconstruction MESHING breast cancer
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Progress in Implant-Based Breast Reconstruction:What Do We Know?
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作者 Xueqing HU Cheng HUANG 《Chinese Journal of Plastic and Reconstructive Surgery》 2021年第2期103-108,共6页
Breast cancer is the most common malignancy and the most frequently diagnosed cancer in women worldwide.In China,the incidence rate of breast cancer among women has been showing an upward trend and is higher in urban ... Breast cancer is the most common malignancy and the most frequently diagnosed cancer in women worldwide.In China,the incidence rate of breast cancer among women has been showing an upward trend and is higher in urban areas.Decades of clinical research have made considerable progress,which is attributable to improved mastectomy and maintenance of a well-perfused skin flap after mastectomy.An in-depth insight into the nature of breast cancer will contribute to reduced overall mortality and prolonged survival.In China,there is an increasing awareness of the importance of breast reconstruction in improving quality of life(QoL)and life expectancy.There has been progress in breast reconstruction surgical procedures due to demand from women.Clinicians should be aware that breast reconstruction is not only a medical problem but also a surgical problem.In the following sections,we present the epitome of advances in implant-based breast reconstruction. 展开更多
关键词 breast reconstruction IMPLANT acellular dermal matrix EXPANDER
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Acellular dermal matrices in reconstructive surgery;history,current implications and future perspectives for surgeons
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作者 Ömer F Dilek Kamuran Z Sevim Osman N Dilek 《World Journal of Clinical Cases》 SCIE 2024年第35期6791-6807,共17页
Large-scale defects of body in the reconstructive surgical practice,and the help-lessness of their repair with autologous tissues,have been an important factor in the development of artificial biological products for ... Large-scale defects of body in the reconstructive surgical practice,and the help-lessness of their repair with autologous tissues,have been an important factor in the development of artificial biological products for the temporary,definitive,or staged repair of these defects.A major advance in the field of plastic and other reconstructive surgery in this regard has been the introduction and successful use of acellular dermal matrices(ADMs).In recent years,not only the type of tissue from which ADMs are produced,product range,diversity and areas of use have increased,but their use in reconstructive fields,especially in post oncologic breast surgery,has become highly regarded and this has favored ADMs to be a potential cornerstone in specific and well-defined surgical fields in future.It is essential that reconstructive surgeons become familiar with some of the ADM’s as well as the advantages and limitations to their use.This review not only provides basic science and clinical evidence of the current use of ADMs in wide range of surgical fields but also targets to keep them as an important backdrop in the arma-mentarium of reconstructive surgeons.Brief considerations of possible future directions for ADMs are also conducted in the end. 展开更多
关键词 acellular dermal matrices breast DECELLULARIZATION reconstruction Surgery Tissue defect
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The Utility of the Galea in Scalp Reconstruction
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作者 Jack D. Sudduth John M. Sullivan Marc E. Walker 《Modern Plastic Surgery》 2023年第1期16-22,共7页
Total scalp avulsion is a time-sensitive, catastrophic injury requiring quick, complex decision-making. Traditionally, these injuries were treated with split-thickness skin grafts. With advancements in microsurgery, t... Total scalp avulsion is a time-sensitive, catastrophic injury requiring quick, complex decision-making. Traditionally, these injuries were treated with split-thickness skin grafts. With advancements in microsurgery, treatments evolved to scalp replantation, becoming the standard of care in scalp reconstruction. Although the integrity of the scalp’s blood vessels is pivotal for successful replantation, the authors believe that scalp replantation should be considered at all costs. In the presented case, a 54-year-old female presented to the emergency room following an incident with an auger that completely avulsed her scalp. She was taken back to the operating room, where scalp replantation was performed. Following replantation, scalp necrosis led to serial debridings in the operating room, and eventually, all of the scalp was debrided down to healthy tissue. Surprisingly, the galea survived despite this, which provided a healthy base for skin grafts. Before definitive coverage was placed, it was decided to utilize a bilaminar acellular dermal matrix along with negative pressure wound therapy to create a more robust bed of granulation tissue. After three weeks of this treatment plan, the patient returned to the operating room, where a healthy, viable bed of granulating tissue was revealed beneath the dermal matrix. Split-thickness skin grafts were taken from her thighs bilaterally and sewn together in a quilt-like fashion to cover the wound bed. The entirety of the graft healed without complication except for one small area that required full-thickness skin grafting in an outpatient setting. Even though the replantation ultimately failed, it allowed the galea to survive, which saved the patient from undergoing a free tissue transfer and allowed her scalp to be reconstructed with split-thickness skin grafts. Even in the setting of polytrauma, the authors hope that anyone treating a scalp avulsion would consider scalp replantation at all costs. 展开更多
关键词 Scalp reconstruction Scalp Replantation Failed Replantation Galea POLYTRAUMA Split-Thickness Skin Grafts Bilaminar acellular dermal matrix
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Biomaterials for tarsal plate reconstruction and our innovative work
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作者 Xing Huang Yi Ding +4 位作者 Lin Lu Rui Jin Sun Di Jun Yang Xusong Luo 《Chinese Journal of Plastic and Reconstructive Surgery》 2021年第3期150-154,共5页
Large tarsal plate defect reconstruction is one of the most challenging tasks for plastic surgeons.Based on our practical work and literature review,the techniques and postoperative results of the preserved sclera,ear... Large tarsal plate defect reconstruction is one of the most challenging tasks for plastic surgeons.Based on our practical work and literature review,the techniques and postoperative results of the preserved sclera,ear cartilage,and acellular dermal matrix(ADM)as tarsal plate substitutes were investigated.Two cases were reviewed.Case 1 was a 22-year-old female who had total loss of the right lower eyelid.Ear cartilage(23 mm25 mm)was implanted under the expanded skin during the forehead skin-expanding procedure to form a skin-cartilageexpander capsule compound structure for lower eyelid reconstruction.Case 2 was a 7-year-old boy with a unilateral divided nevus.The lid and conjunctiva of the lower eyelid were invaded.A piece of ADM(12 mm4 mm)was used to repair the tarsal plate defect(12 mm3 mm).The conjunctiva of ADM was covered by itself.An orbicularis oculi myocutaneous flap was used for anterior lamella reconstruction.In case 1,the compound tissue survived and supported the lower eyelid,the lid margin was clear,and the structure was complete over a 1-year follow-up.The aesthetic appearance of the eyelid improved after depilation.It is the first clinical research on the expander capsule as eyelid conjunctiva.In case 2,the conjunctiva completely covered the superior ADM,and the transplant merged with the surrounding tissues without complications after 5 months.The preserved sclera has the longest application history as a tarsal plate substitute.However,it should be preserved in an eye bank and transplanted with conjunctiva repair.Ear cartilage is an autologous tissue that requires conjunctival reconstruction.Our clinical practice was the first to prove the possibility of the expander capsule as eyelid conjunctiva.It is feasible to prefabricate the skin-tarsal conjunctiva complex during the skin expansion procedure.Allogeneic ADM is a common clinical material with advantages of good biological histocompatibility,supportive strength,conjunctivalization,and not requiring donor site surgery.Plastic surgeons are familiar with autologous ear cartilage and ADM,which are easy to obtain and treat.Both ear cartilage and ADM are expected to be the first-line choices in future studies. 展开更多
关键词 Tarsal plate reconstruction Ear cartilage Preserved sclera acellular dermal matrix Conjunctival repair Expander capsule
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脱细胞真皮与异体巩膜在眼睑重建中的实验研究 被引量:14
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作者 顾建军 陈家祺 +4 位作者 彭鸿钧 黄挺 陈龙山 周世有 何玉良 《眼科研究》 CSCD 北大核心 2003年第3期229-233,共5页
目的 了解脱细胞真皮植入兔眼睑后的组织相容性 ,比较脱细胞真皮与异体巩膜替代睑板后的组织转归。方法  16只新西兰白兔 ,随机平均分成两组 ,在去除右下睑 5mm× 10mm的全层睑板后 ,分别植入脱细胞真皮和异体巩膜 ,观察大体情况... 目的 了解脱细胞真皮植入兔眼睑后的组织相容性 ,比较脱细胞真皮与异体巩膜替代睑板后的组织转归。方法  16只新西兰白兔 ,随机平均分成两组 ,在去除右下睑 5mm× 10mm的全层睑板后 ,分别植入脱细胞真皮和异体巩膜 ,观察大体情况和血液中免疫学指标的改变 ,分别于术后 1、4、8、12周取出植片 ,光镜检查组织学的改变 ,取第 4周的植片做免疫组化检查。结果 脱细胞真皮植入眼睑后结膜充血水肿消退较快 ,无植入物排斥 ,两组血液中抗体和CD 4、CD 8细胞的改变无明显差异 ,组织学检查显示脱细胞真皮引起的免疫和炎症反应轻微。作为一种生物支架 ,可以引导受体新生血管和胶原纤维的长入。结论 脱细胞真皮在植入兔眼睑后有较好的组织相容性 ,并可引导新生胶原的生长 。 展开更多
关键词 脱细胞真皮 异体巩膜 眼睑重睑
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异种脱细胞真皮基质修复膜在口腔黏膜下纤维性变手术治疗中的应用 被引量:10
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作者 蒋灿华 李超 +3 位作者 石芳琼 陈新群 唐瞻贵 翦新春 《上海口腔医学》 CAS CSCD 2011年第3期273-277,共5页
目的:评价异种脱细胞真皮基质修复膜在口腔黏膜下纤维性变手术治疗中的应用效果。方法:8例重度口腔黏膜下纤维性变患者,经鼻腔气管插管全麻下切除双侧颊部翼下颌韧带前方区域纵行的纤维条索,术中被动开口度达正常范围后,剪取相应大小的... 目的:评价异种脱细胞真皮基质修复膜在口腔黏膜下纤维性变手术治疗中的应用效果。方法:8例重度口腔黏膜下纤维性变患者,经鼻腔气管插管全麻下切除双侧颊部翼下颌韧带前方区域纵行的纤维条索,术中被动开口度达正常范围后,剪取相应大小的异种脱细胞真皮基质修复膜覆盖黏膜缺损创面,间断缝合后,碘纺纱包加压固定。术后10~14d拆除纱包与缝线后开始开口训练,定期随访并进行类固醇皮质激素黏膜下局部注射等辅助治疗,通过伤口愈合、瘢痕软化及开口度改善等指标评价手术效果。采用SPSS16.0软件包对数据进行单因素方差分析。结果:8例患者双侧颊部纤维条索切除后形成的手术创面,采用异种脱细胞真皮基质修复膜进行修复均获得成功,无感染或排异等并发症发生。术后随访6~18个月,患者颊部原手术区黏膜红润,质地柔软,开口困难明显改善。术前开口度为(12.04±2.93)mm,术中开口度为(35.46±3.17)mm,术后6个月时的开口度为(29.33±4.28)mm,经统计学分析,差异具有显著性(P<0.05)。结论:应用异种脱细胞真皮基质修复膜修复重度口腔黏膜下纤维性变手术治疗中的黏膜缺损创面,能够起到促进创面早期愈合、减轻瘢痕形成与改善开口困难的作用,其操作简单易行,值得临床推广应用。 展开更多
关键词 口腔黏膜下纤维性变 异种脱细胞真皮基质修复膜 口腔黏膜缺损 修复重建
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16年95例阴道成形术的临床分析 被引量:13
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作者 郝焰 卢丹 +4 位作者 郑平 张亚兰 吴霞 周琦 段爱红 《中国微创外科杂志》 CSCD 2011年第7期604-608,共5页
目的探讨先天性无阴道的治疗方法。方法回顾性分析1995年1月1日~2010年12月31日95例阴道成形术的临床资料,并对自体皮片法(n=43)、腹腔镜腹膜法(n=13)及脱细胞异体真皮法(acellular dermal matrix,ADM)(n=10)三种术式的术中... 目的探讨先天性无阴道的治疗方法。方法回顾性分析1995年1月1日~2010年12月31日95例阴道成形术的临床资料,并对自体皮片法(n=43)、腹腔镜腹膜法(n=13)及脱细胞异体真皮法(acellular dermal matrix,ADM)(n=10)三种术式的术中情况、术后住院时间以及随访情况等进行对比。结果(1)手术时间ADM法(54.4±7.7)min〈腹腔镜腹膜法(93.5±22.4)min〈自体皮片法(122.1±28.8)rain(P均=0.00)。术中出血ADM法(34.4±26.7)ml〈腹腔镜腹膜法(84.6±57.4)ml和自体皮片法(91.3±43.8)ml(P分别为0.02、0.00),腹腔镜腹膜法与自体皮片法差异无显著性(P=0.65)。术后住院时间ADM法(16.1±2.9)d和腹腔镜腹膜法(20.8±7.1)d〈自体皮片法(35.3±13.9)d(P均=0.00),ADM法与腹腔镜腹膜法差异无显著性(P=0.46)。(2)并发症情况:自体皮片法发生并发症12例(27.9%),其中3例皮瓣脱落,9例术后病率;腹腔镜腹膜法发生并发症6例(46.2%),1例阴道顶端缝线松脱,5例术后病率;ADM法发生并发症1例(10.0%),为术后病率。3组间并发症发生率及术后病率差异均无显著性(P〉0.05)。(3)术后随访情况:自体皮片法、腹腔镜腹膜法及ADM法阴道长度分别为(7.82±1.01)cm、(7.31±1.32)cm及(8.39±0.60)cm;阴道宽度≥3cm者三组分别有32、9、10例,三组比较差异无显著性(P分别=0.064、0.612)。结论应用ADM行阴道成形术,避免了自体移植的损伤和其他异体材料准备的繁琐,手术方法简单,手术风险降低,在阴道成形术的应用中具有一定前景。 展开更多
关键词 先天性无阴道 阴道成形术 脱细胞异体真皮
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异种脱细胞真皮基质修复膜在口腔黏膜组织缺损修复中的应用 被引量:20
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作者 徐明耀 陈勇 王志勇 《口腔医学研究》 CAS CSCD 2008年第6期657-659,共3页
目的:评价异种脱细胞真皮基质修复膜在口腔黏膜组织缺损修复中的应用效果。方法:收集2007年1月至10月应用异种脱细胞真皮基质修复膜进行口腔黏膜组织缺损修复的60例患者资料。术后进行追踪随访和功能评价。结果:术后随访10~18个月,平... 目的:评价异种脱细胞真皮基质修复膜在口腔黏膜组织缺损修复中的应用效果。方法:收集2007年1月至10月应用异种脱细胞真皮基质修复膜进行口腔黏膜组织缺损修复的60例患者资料。术后进行追踪随访和功能评价。结果:术后随访10~18个月,平均14个月。60例患者中,59例患者的黏膜组织缺损修复均获得成功,术后7~10 d未见修复膜脱落,愈合良好。1例病灶累及软腭,术后出现基质溶解,出现穿通,造成口鼻瘘,修复失败。成活后的修复膜在软组织部位受植床存在一定的收缩。结论:应用异种脱细胞真皮基质修复膜能够起到早期覆盖创面,促进创面愈合,减轻瘢痕生成的作用。其操作简单易行,是一种值得推广的修复方法。 展开更多
关键词 异种脱细胞真皮基质修复膜 口腔黏膜缺损 修复重建
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脱细胞异体真皮基质修复口腔上皮缺损的临床评价 被引量:13
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作者 侯劲松 廖贵清 +3 位作者 黄洪章 杨小平 唐海阔 陶谦 《中国口腔颌面外科杂志》 CAS 2006年第6期427-429,共3页
目的:评价脱细胞异体真皮基质(acellulardermalmatrix,ADM)修复口内上皮缺损的临床效果。方法:收集2002年7月~2005年12月应用ADM修复口内黏膜缺损和移植组织瓣上皮不足的52例患者的病例资料,并追踪随访1~12个月,对近期效果和远期效果... 目的:评价脱细胞异体真皮基质(acellulardermalmatrix,ADM)修复口内上皮缺损的临床效果。方法:收集2002年7月~2005年12月应用ADM修复口内黏膜缺损和移植组织瓣上皮不足的52例患者的病例资料,并追踪随访1~12个月,对近期效果和远期效果进行分析。结果:以ADM修复口腔黏膜缺损51例,除1例发生基质溶解外,其余ADM全部成活。修复后2周左右,修复区色泽与周围组织相近。随访发现,修复舌缺损近期效果好,舌活动度佳,1~2个月后可见修复区组织收缩,3个月后最明显,舌活动度受影响;颊部修复区可见类似结果;修复前庭沟可见前庭沟变浅,累及唇部,可出现轻度活动受限。用于牙槽突、硬腭等骨性创面修复,则远期效果良好。另以ADM修复髂骨肌皮瓣移植后皮岛面积不足1例,临床效果与骨性创面类似。结论:ADM修复口内上皮缺损成活率高,覆盖创面效果好,无瘢痕形成,是较理想的口腔上皮缺损修复材料,但应考虑修复后局部收缩对软组织活动度的影响。 展开更多
关键词 脱细胞异体真皮基质 移植 修复重建 上皮缺损
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异种脱细胞真皮基质与重建腮腺嚼肌筋膜预防腮腺切除术后味觉出汗综合征的比较研究 被引量:14
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作者 赵健 余洪强 刘阿贵 《口腔医学》 CAS 2011年第6期356-359,共4页
目的比较异种脱细胞真皮基质和重建腮腺咬肌筋膜预防腮腺手术后味觉出汗综合征的效果。方法将2005年1月—2008年10月无锡市第四人民医院口腔科收治的腮腺良性肿瘤患者87例,随机分为4组:①对照组(A组)15例,单纯行不保留咬肌筋膜的腮腺肿... 目的比较异种脱细胞真皮基质和重建腮腺咬肌筋膜预防腮腺手术后味觉出汗综合征的效果。方法将2005年1月—2008年10月无锡市第四人民医院口腔科收治的腮腺良性肿瘤患者87例,随机分为4组:①对照组(A组)15例,单纯行不保留咬肌筋膜的腮腺肿瘤及浅叶组织切除;②胸锁乳突肌肌瓣组(B组)23例,不保留腮腺嚼肌筋膜的腮腺肿瘤及腮腺组织切除后,缺损处表面覆盖胸锁乳突肌肌瓣。③腮腺咬肌筋膜瓣组(C组)22例,切除腮腺肿瘤及腮腺组织时保留腮腺咬肌筋膜;④异种脱细胞真皮基质组(C组)27例,行不保留咬肌筋膜的腮腺肿瘤及腮腺组织叶切除术后,根据缺损大小植入异种脱细胞真皮基质。结果所有病例术后随访12个月时,进行主观评价及客观评价,A组10/15例(66.67%)、B组4/23例(17.39%)、C组2/22例(9.09%)、D组1/27例(3.70%)出现味觉出汗综合征。D组与C组和第B、A组比较,有显著统计学差异(P<0.05),D组与C组两者之间并无明显统计学差异。结论保留腮腺咬肌筋膜能够预防味觉出汗综合征,对于无法保留腮腺咬肌筋膜者利用异体脱细胞真皮基质也同样能够较好的预防味觉出汗综合征发生。 展开更多
关键词 异种脱细胞真皮基质 腮腺咬肌筋膜重建 腮腺切除术 味觉出汗综合征
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小鼠阴道上皮细胞与猪脱细胞真皮基质-纤维蛋白凝胶构建组织工程阴道的初步研究 被引量:3
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作者 张明乐 黄向华 +3 位作者 李雅钗 张琳 李亚楠 朱志洁 《实用妇产科杂志》 CAS CSCD 北大核心 2012年第8期639-642,共4页
目的:初步探讨利用组织工程学技术构建组织工程阴道的方法及可行性。方法:将小鼠阴道上皮细胞以1×105个/ml的密度接种到纤维蛋白凝胶内并与猪脱细胞真皮基质(PADM)复合构成移植片,体外培养48小时后,将移植片埋植到小鼠脊柱两侧皮... 目的:初步探讨利用组织工程学技术构建组织工程阴道的方法及可行性。方法:将小鼠阴道上皮细胞以1×105个/ml的密度接种到纤维蛋白凝胶内并与猪脱细胞真皮基质(PADM)复合构成移植片,体外培养48小时后,将移植片埋植到小鼠脊柱两侧皮下。移植后2周、4周、8周和12周取材,对埋植后不同时间取出的移植片行HE染色和VanGieso(VG)染色,观察和评价移植片组织的生长状况;用上皮广谱角蛋白单克隆抗体AE1/AE3进行免疫组化染色,以证实移植片是否存在上皮组织。结果:光镜下观察,皮下埋植后2周,可见少量阴道上皮细胞,4周形成上皮,仅2~3层,8~12周上皮层数增加(约4~5层)。AE1/AE3免疫组化染色结果与HE染色结果一致。VG染色显示随埋植时间推移,PADM内逐渐有细胞长入,结构逐渐降解。结论:阴道上皮细胞与PADM-纤维蛋白构建的移植物体内移植后有血管长入,形成的上皮组织表型与正常阴道上皮表型相同。 展开更多
关键词 阴道重建 组织工程 细胞培养 猪脱细胞真皮基质
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原位与体内构建小鼠组织工程阴道的实验研究 被引量:3
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作者 张明乐 黄向华 +4 位作者 李雅钗 张琳 李亚楠 朱志洁 王振海 《实用妇产科杂志》 CAS CSCD 北大核心 2013年第4期277-281,共5页
目的:比较原位组织构建与体内构建两种方式在小鼠体内进行阴道重建的效果。方法:切除昆明小鼠阴道后采用酶消化法获得阴道上皮细胞。A组(12只)植入猪脱细胞真皮基质(PADM)行原位组织构建;B组(12只)植入自体阴道上皮细胞与纤维蛋白-PADM... 目的:比较原位组织构建与体内构建两种方式在小鼠体内进行阴道重建的效果。方法:切除昆明小鼠阴道后采用酶消化法获得阴道上皮细胞。A组(12只)植入猪脱细胞真皮基质(PADM)行原位组织构建;B组(12只)植入自体阴道上皮细胞与纤维蛋白-PADM移植复合物行体内构建。于移植后2周、4周、8周、12周取出重建的阴道组织进行大体观察,并分别进行伊红-美蓝染色(HE)、Van Gieso(VG)染色和广谱角蛋白AE1/AE3免疫组化染色,以动态观察重建阴道组织生长情况及PADM降解情况。重建术后12周用透射电镜观察重建阴道组织超微结构。结果:①A组在移植后2周可见2~3层细胞的上皮形成;移植后4周细胞层数增加,但细胞排列无极向;移植后8周、12周上皮层结构接近正常小鼠阴道上皮层结构。B组移植后2周上皮结构即接近正常小鼠阴道上皮结构;移植后4周、8周、12周上皮层结构基本同移植后2周,但细胞形态更加成熟,极向更为明显。移植后12周A组PADM部分区域结构不完整,B组PADM仍保持基本轮廓。②AE1/AE3免疫组化染色证实了重建阴道的上皮化。③B组透射电镜观察可见上皮细胞之间存在桥粒连接,上皮细胞与基底膜之间有半桥粒连接。上皮层下见成纤维细胞、无髓神经纤维与毛细血管。结论:利用PADM进行原位组织构建与体内构建在实验动物体内均能够完成阴道重建。在技术成熟的条件下,体内构建法比原位组织构建法更适合于进行阴道重建。 展开更多
关键词 阴道重建 组织工程 脱细胞真皮基质 纤维蛋白凝胶 阴道上皮细胞
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异种(牛)脱细胞真皮在结膜囊成形术中的临床应用 被引量:4
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作者 高长华 张向荣 +1 位作者 周琼 裴重刚 《眼科新进展》 CAS 北大核心 2012年第7期648-650,653,共4页
目的探讨采用异种(牛)脱细胞真皮作为移植材料行结膜囊成形术的安全性及效果。方法 9例(9眼)眼内容摘出术后结膜囊狭窄患者,行义眼座植入联合结膜囊成形术,术中应用Medpor义眼座作为眼窝填充材料、异种(牛)脱细胞真皮作为结膜生长支架... 目的探讨采用异种(牛)脱细胞真皮作为移植材料行结膜囊成形术的安全性及效果。方法 9例(9眼)眼内容摘出术后结膜囊狭窄患者,行义眼座植入联合结膜囊成形术,术中应用Medpor义眼座作为眼窝填充材料、异种(牛)脱细胞真皮作为结膜生长支架移植材料。义眼座植入后行结膜囊成形术,将异种脱细胞真皮修剪后移植于结膜缺损处,放入眼模,缝合睑缘,术后抗炎治疗3个月拆除睑缘缝线。随访观察6~18个月,平均8个月。结果 9例患者术后均无明显排斥反应,无义眼座暴露;植片色泽逐渐红润,无坏死、脱落及明显收缩,结膜上皮爬行并覆盖植片表面。术后3个月植片近似正常结膜外观,结膜囊成形好,配戴义眼片后患眼外观良好,不滑脱。9例患者中8例效果良好,1例一般。结论采用异种(牛)脱细胞真皮作为结膜囊成形移植材料,手术操作方便,异种脱细胞真皮组织相容性好,结膜囊成形效果满意。 展开更多
关键词 异种(牛)脱细胞真皮 异种移植 结膜囊狭窄 结膜囊成形术
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口腔组织补片修复颊黏膜缺损 被引量:2
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作者 徐剑波 陈峰 张培娟 《中国耳鼻咽喉头颈外科》 CSCD 2013年第6期327-328,共2页
临床上多种因素可以引起颊黏膜的缺损,修复的方法多种,如局部邻近转移黏膜瓣、颊脂垫瓣、游离皮肤移植等,但这些方法存在许多不足,随着组织工程学的发展,一种新型的真皮替代物一脱细胞异体真皮基质(组织补片)已经在烧伤和整形领... 临床上多种因素可以引起颊黏膜的缺损,修复的方法多种,如局部邻近转移黏膜瓣、颊脂垫瓣、游离皮肤移植等,但这些方法存在许多不足,随着组织工程学的发展,一种新型的真皮替代物一脱细胞异体真皮基质(组织补片)已经在烧伤和整形领域中皮肤的移植上成功应用。我科应用同种异体脱细胞真皮基质修复因手术造成的颊黏膜缺损21例,取得了较为较好的效果,现报道如下。 展开更多
关键词 口腔黏膜(Mouth Mucosa) 创伤和损伤(Wounds and Injuries) 修复外科手术(Reconstructive Surgical Procedures) 口腔组织补片(acellular dermal matrix)
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异体脱细胞真皮基质膜修复舌癌切除后组织缺损的手术配合
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作者 张怡 王银莲 +1 位作者 易艳 陈银霞 《中国现代医学杂志》 CAS CSCD 北大核心 2011年第20期2447-2449,共3页
目的介绍异体脱细胞真皮基质膜修复舌癌术中组织缺损的手术配合经验。方法通过总结16例舌颈联合根治加异体脱细胞真皮基质膜修复手术的洗手巡回配合经念,归纳了这类手术的配合要点和注意事项。结果 16例手术均获得满意效果,未见患者出... 目的介绍异体脱细胞真皮基质膜修复舌癌术中组织缺损的手术配合经验。方法通过总结16例舌颈联合根治加异体脱细胞真皮基质膜修复手术的洗手巡回配合经念,归纳了这类手术的配合要点和注意事项。结果 16例手术均获得满意效果,未见患者出现术后组织膜裂开、脱落和排斥反应,全部成活。结论结合手术特点,重视理论和实践相结合,加强术中护理是手术成功的重要条件。 展开更多
关键词 异体脱细胞基质膜 舌癌修复 手术配合
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自体口腔黏膜微粒联合脱细胞异体真皮基质再造阴道的临床探讨 被引量:2
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作者 牛琴 《中国医疗美容》 2017年第12期19-22,共4页
目的自体口腔黏膜微粒联合ADM(脱细胞异体真皮基质)再造阴道的临床探讨。方法择本院2009年11月-2015年11月收治的先天性无阴道的81例患者资料实施回顾性的分析,对所有患者联合实施口腔黏膜微粒与ADM再造阴道法,观察术后患者再造阴道的... 目的自体口腔黏膜微粒联合ADM(脱细胞异体真皮基质)再造阴道的临床探讨。方法择本院2009年11月-2015年11月收治的先天性无阴道的81例患者资料实施回顾性的分析,对所有患者联合实施口腔黏膜微粒与ADM再造阴道法,观察术后患者再造阴道的上皮化及脱离磨具时间,且在治疗后1年实施再造阴道的容积、周径及深度的测量,评定患者的性生活质量。结果所有患者的手术治疗皆已成功,经随访得知,再造阴道的上皮化时间是(10.28±3.24)d;再造阴道的容积是(110.12±11.21)m L;其中68例存在性生活的患者FSFI分数是(31.39±2.85)分。结论自体口腔黏膜微粒与脱细胞异体真皮基质联合再造阴道效果佳。 展开更多
关键词 再造阴道 脱细胞异体真皮基质 自体口腔黏膜微粒
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