The Application of Bilayer Artificial Dermis Combined with VSD Technology in Chronic Wounds

Background: Bilayer artificial dermis promotes wound healing and offers a treatment option for chronic wounds. Aim: Examine the clinical efficacy of bilayer artificial dermis combined with Vacuum Sealing Drainage (VSD) technology in the treatment of chronic wounds. Method: From June 2021 to December 2023, our hospital treated 24 patients with chronic skin tissue wounds on their limbs using a novel tissue engineering product, the bilayer artificial dermis, in combination with VSD technology to repair the wounds. The bilayer artificial dermis protects subcutaneous tissue, blood vessels, nerves, muscles, and tendons, and also promotes the growth of granulation tissue and blood vessels to aid in wound healing when used in conjunction with VSD technology for wound dressing changes in chronic wounds. Results: In this study, 24 cases of chronic wounds with exposed bone or tendon larger than 1.0 cm2 were treated with a bilayer artificial skin combined with VSD dressing after wound debridement. The wounds were not suitable for immediate skin grafting. At 2 - 3 weeks post-treatment, good granulation tissue growth was observed. Subsequent procedures included thick skin grafting or wound dressing changes until complete wound healing. Patients were followed up on average for 3 months (range: 1 - 12 months) post-surgery. Comparative analysis of the appearance, function, skin color, elasticity, and sensation of the healed chronic wounds revealed superior outcomes compared to traditional skin fl repairs, resulting in significantly higher satisfaction levels among patients and their families. Conclusion: The application of bilayer artificial dermis combined with VSD technology for the repair of chronic wounds proves to be a viable method, yielding satisfactory therapeutic effects compared to traditional skin flap procedures.

Artificial dermis combined with skin grafting for the treatment of hand skin and soft tissue defects and exposure of bone and tendon

BACKGROUND The recovery time of hand wounds is long,which can easily result in chronic and refractory wounds,making the wounds unable to be properly repaired.The treatment cycle is long,the cost is high,and it is prone to recurrence and disability.Double layer artificial dermis combined with autologous skin transplantation has been used to repair hypertrophic scars,deep burn wounds,exposed bone and tendon wounds,and post tumor wounds.AIM To investigate the therapeutic efficacy of autologous skin graft transplantation in conjunction with double-layer artificial dermis in treating finger skin wounds that are chronically refractory and soft tissue defects that expose bone and tendon.METHODS Sixty-eight chronic refractory patients with finger skin and soft tissue defects accompanied by bone and tendon exposure who were admitted from July 2021 to June 2022 were included in this study.The observation group was treated with double layer artificial dermis combined with autologous skin graft transplantation(n=49),while the control group was treated with pedicle skin flap transplantation(n=17).The treatment status of the two groups of patients was compared,including the time between surgeries and hospital stay.The survival rate of skin grafts/flaps and postoperative wound infections were evaluated using the Vancouver Scar Scale(VSS)for scar scoring at 6 mo after surgery,as well as the sensory injury grading method and two-point resolution test to assess the recovery of skin sensation at 6 mo.The satisfaction of the two groups of patients was also compared.RESULTS Wound healing time in the observation group was significantly longer than that in the control group(P<0.05,27.92±3.25 d vs 19.68±6.91 d);there was no significant difference in the survival rate of skin grafts/flaps between the two patient groups(P>0.05,95.1±5.0 vs 96.3±5.6).The interval between two surgeries(20.0±4.3 d)and hospital stay(21.0±10.1 d)in the observation group were both significantly shorter than those in the control group(27.5±9.3 d)and(28.4±17.7 d),respectively(P<0.05).In comparison to postoperative infection(23.5%)and subcutaneous hematoma(11.8%)in the control group,these were considerably lower at(10.2%)and(6.1%)in the observation group.When comparing the two patient groups at six months post-surgery,the excellent and good rate of sensory recovery(91.8%)was significantly higher in the observation group than in the control group(76.5%)(P<0.05).There was also no statistically significant difference in two point resolution(P>0.05).The VSS score in the observation group(2.91±1.36)was significantly lower than that in the control group(5.96±1.51),and group satisfaction was significantly higher(P<0.05,90.1±6.3 vs 76.3±5.2).CONCLUSION The combination of artificial dermis and autologous skin grafting for the treatment of hand tendon exposure wounds has a satisfactory therapeutic effect.It is a safe,effective,and easy to operate treatment method,which is worthy of clinical promotion.

Use of Artificial Dermis and Cultured Epithelial Autograft for Extensive Deep Dermal Burns —A Case Report

In the treatment of extensive burns, cultured epithelial autograph (CEA) became available commercially in Japan from 2009. Based on the 6 years multicenter surveillance data on using CEA for extensive burns, it is reported that using 6:1 split thickness skin graft together with CEA is successful after wound bed preparation for extensive deep dermal burn or patients with deep burn [1].

Effect of artificial dermis combined with jinfu ning on skin healing and bacterial detection rate of finger abdomen

Objective: To explore the effect of artificial dermis combined with rhGM-CSF(Jinfuning) on healing of soft tissue defect of finger ventral skin and the influence of bacterial detection rate. Methods: Totally 110 patients with finger injury admitted to the rehabilitation department of our department from January 2017 to June 2018 were collected and divided into control group and observation group according to the random number table method with 55 cases in each group. The control group received direct artificial derma lrepairing after thorough debridement, while the observation group received recombinant gm-csf gel coating on the wound surface before artificial dermal repairing, Wound healing, wound inflammation, bacterial detection rate, inflammatory factor expression, follow-up and adverse reactions were compared between the two groups. Results: The wound healing rate of the observation group at 7, 14, 21 and 28 days after treatment was significantly higher than that of the control group (t= 11.211, P =0.000).( T = 14.895, P =0.000;T = 25.346, P=0.000;T =8.247, P=0.000). The wound healing time of the observation group was (19.7±2.3) d, and that of the control group was (27.4±3.3) d. The average wound healing time of the observation group was significantly shorter than that of the control group, and the difference was statistically significant (t=14.197, P= 0.000). Observation group wound inflammation at each time point score was significantly lower than the control group, the group rooms, time points, ·point interaction effect between the comparison, the differences were statistically significant (P <0.05), the observation group wound bacteria detection rate of 7.27% (4 cases) : the control bacteria detection rate was 21.81% (12 cases), difference was statistically significant (chi-square = 4.68, P= 0.0305), the observation group of bacteria detection rate was significantly lower than the control group;The bacteria detected in the two groups were mainly e. coli, tetanus bacillus and fungi. There was no significant difference in the indicators between the two groups before treatment, and the values of inflammatory cytokines il-1 and TNF- IOD in the two groups were significantly decreased after treatment, and the observation group was significantly lower than the control group, with statistically significant differences (P < 0.05). No serious adverse reactions occurred in either group during the treatment. Conclusion: the application of artificial dermals combined with jinfuning can promote wound healing of skin and soft tissue defect of finger abdomen, effectively inhibit bacterial infection of wound surface, reduce inflammation and infection,reducing bacterial detection rate.

双层人工真皮联合诱导膜技术修复足踝部皮肤缺损伴感染的疗效

目的 探讨双层人工真皮联合诱导膜技术修复足踝部皮肤缺损伴感染的疗效。方法 按创面缺损修复方式不同将64例足踝部皮肤缺损伴感染患者分为对照组(采用双层人工真皮修复后全厚皮片移植治疗,32例)和观察组(采用双层人工真皮联合诱导膜技术修复后全厚皮片移植治疗,32例)。记录两组人工真皮血管化时间、创面感染情况、移植皮片成活情况。采用温哥华瘢痕量表(VSS)评分评价植皮区瘢痕情况,采用AOFAS踝-后足评分评估踝关节功能恢复情况。结果 患者均获得12个月随访。人工真皮血管化时间观察组短于对照组(P<0.05)。移植皮片成活率观察组高于对照组(P<0.05)。创面感染率观察组低于对照组(P<0.05)。术后12个月VSS评分、AOFAS踝-后足评分两组比较差异均无统计学意义(P>0.05)。结论 双层人工真皮联合诱导膜技术修复足踝部皮肤缺损伴感染,手术操作相对简单易行,对供区损伤小,且可以明显缩短双层人工真皮血管化时间,提高创面修复成功率,降低创面感染率。

人工真皮联合自体瘢痕表皮移植修复大面积烧伤后期关节部位瘢痕畸形

背景:如何既为大面积深度烧伤患者瘢痕整形修复提供足够的皮源,又能避免术区创面瘢痕的再次增生,一直是烧伤与创面修复研究的重要课题。目的:观察人工真皮联合自体瘢痕表皮复合移植在大面积烧伤后瘢痕整复中的临床应用效果。方法:回顾性分析2021年1月至2023年1月在蚌埠医学院附属蚌埠第三人民医院接受手术治疗的大面积烧伤后瘢痕增生、挛缩畸形患者的病历资料,共纳入73例,按照治疗方法分为3组:A组(n=21)接受人工真皮联合自体瘢痕表皮移植治疗;B组(n=27)接受功能部位瘢痕松解后移植自体瘢痕表皮治疗;C组(n=25)接受功能部位瘢痕松解后移植自体中厚皮治疗。记录3组患者受皮区皮片存活及感染情况,受皮区及供皮区创面愈合时间;通过温哥华瘢痕量表(VSS)、日常生活活动能力(ADL)评定3组患者受皮区、供皮区瘢痕情况及受皮区功能恢复情况。结果与结论:①B组患者皮片感染率低于A、C组(P<0.05),皮片存活优级率高于A、C组(P<0.05);②A组患者受皮区创面完全愈合时间长于B、C组(P<0.05),C组患者受皮区创面完全愈合时间长于B组(P<0.05);C组患者供皮区完全愈合时间长于A、B组(P<0.05);③B组患者术后12个月受皮区温哥华瘢痕量表评分高于A、C组(P<0.05),C组患者术后6,12个月供皮区温哥华瘢痕量表评分高于A、B组(P<0.05);A、C组患者术后12个月日常生活活动能力量表评估优级高于B组(P<0.05);④结果显示,应用人工真皮与自体瘢痕表皮复合移植治疗大面积烧伤后瘢痕挛缩,既能达到与中厚皮移植同样的效果,又能避免供皮区术后瘢痕的再次增生,可缩短供皮区创面愈合时间,相较于单纯移植瘢痕表皮治疗有明显优势。

人工真皮治疗创伤创面疗效评估及真皮血管化影响因素

目的评估人工真皮治疗创伤创面临床疗效及探析人工真皮血管化时间的影响因素。方法采用前瞻性研究方法,纳入佛山市中医院修复重建外科2020年1月至2023年5月收治的创伤致全层皮肤缺损患者130例作为研究对象,评估人工真皮治疗的临床效果;采用单因素方差分析、多重线性回归分析人工真皮血管化的影响因素。结果130例患者创面均愈合良好,有效率100%,人工真皮血管化时间平均为(14.36±2.40)d。多重线性回归分析结果显示,人工真皮血管化时间的影响因素包括年龄、吸烟、糖尿病及术前Bates-Jensen伤口评估工具(BWAT)得分(P<0.05)。结论人工真皮治疗创伤创面疗效明确,年龄、吸烟、糖尿病及术前BWAT得分是人工真皮血管化时间的重要影响因素。在临床工作中,留意高龄患者,劝解患者戒烟、控制饮食、养成良好的生活习惯,对不同患者实施针对性措施以促进人工真皮修复患者创面快速愈合。

中西医结合治疗1例富尼埃坏疽

富尼埃坏疽(Fournier坏疽)是以坏死性筋膜炎为病理表现的特殊感染性疾病,起病急骤,病情凶险,治疗难度大。该文分析1例Fournier坏疽患者的诊疗经过,将先进医疗技术与传统中医疗法相结合,快速清除病灶,启动修复,促进愈合。

人工真皮覆盖修复指端缺损的疗效

目的探讨人工真皮覆盖修复指端缺损的疗效。方法采用人工真皮覆盖修复25例指端缺损患者(30指)。记录创面愈合情况、瘢痕形成情况、指端感觉功能恢复情况。根据中华医学会手外科学会上肢部分功能评定试用标准评定手功能恢复情况,采用Michigan手概况调查表评定患者对术后手指的主观满意度。结果患者均获得随访,时间3~20个月。创面全部愈合,时间4~6(4.7±0.5)周。术后3个月,温哥华瘢痕量表(VSS)评分0~4(1.2±1.0)分,无明显瘢痕形成;两点辨别觉4~12(7.5±3.5)mm;指端感觉功能恢复情况:S4级10指,S3+级13指,S3级4指,S2级3指。术后3个月,手功能恢复情况:优24指,良4指,差2指;患者对术后手指的主观满意度:非常满意19指,满意9指,一般2指。结论采用人工真皮覆盖修复指端缺损操作简单,临床效果良好,尤其适合基层医院开展。

不同人工真皮结合自体刃厚皮片移植修复骨质肌腱外露创面的疗效对比

目的:对比不同人工真皮结合自体刃厚皮片移植修复骨质肌腱外露创面的临床及美学效果。方法:回顾性分析2019年5月-2022年5月在笔者医院进行创面修复治疗的60例骨质肌腱外露创面患者临床资料,根据患者手术方式不同,将采用皮能快愈双层人工真皮结合自体刃厚皮片移植修复者纳入对照组(n=37),将采用国产双层人工真皮结合自体刃厚皮片移植修复者纳入研究组(n=23)。对比两种修复方式移植效果及皮片成活情况。结果:两组植皮次数、并发症发生率及皮片成活率比较比较差异无统计学意义(P>0.05),研究组移植间隔时间长于对照组(P<0.05);两组在治疗后3、7、14 d的白细胞介素-1、肿瘤坏死因子、白细胞介素-12、γ干扰素水平比较差异均无统计学意义(P>0.05);两组治疗后3 d的转化生长因子β1、血管内皮生长因子水平比较差异均无统计学意义(P>0.05),但研究组治疗后7、14 d的转化生长因子β1、血管内皮生长因子均低于对照组(P<0.05);治疗后3个月,两组温哥华瘢痕量表评分比较差异无统计学意义(P>0.05)。结论:在骨质肌腱外露创面修复治疗中,国产双层人工真皮结合自体刃厚皮片与皮能快愈双层人工真皮结合自体刃厚皮片移植效果相当,但存在移植时间间隔较长的弊端,可能与创面组织生长因子水平略低有关。

人工真皮覆盖修复趾黏液囊肿切除术后缺损创面

2015年1月~2021年6月,我科采用囊肿切除术治疗9例趾黏液囊肿患者,并用人工真皮覆盖修复缺损创面,疗效满意,报道如下。1材料与方法1.1病例资料本组9例,男8例,女1例,年龄46~71岁。左趾4例,右趾5例。均伴不同程度的皮肤破溃,透明黏液样物质流出,不伴感染。

双层人工真皮修复指端缺损

2021年1月~2022年1月,我科采用双层人工真皮治疗7例指端缺损患者,效果满意,报道如下。1材料与方法1.1病例资料本组7例(8指),男5例,女2例,年龄26~48岁。左示指1指、中指3指、环指1指,右示指1指、中指2指。均为指端横行Ⅱ度缺损,所有创面污染严重。创面大小1.2 cm×0.7 cm~1.5 cm×1.0 cm。术前行清创、负压治疗,待创面新鲜化、无感染后行Lando双层人工真皮修复。伤后至手术时间1.5~6 h。

人工真皮结合自体刃厚皮片治疗上肢热压伤的疗效观察

目的:探讨人工真皮结合自体刃厚皮片治疗上肢热压伤的临床效果。方法:选择笔者医院2020年6月-2022年3月收治的因热压伤导致上肢皮肤缺损患者12例,其中全层皮肤损伤7例,合并肌腱外露5例。所有患者创面清创切痂后行人工真皮植入术,待人工真皮血管化后行自体刃厚皮片移植修复创面,观察记录术后创面愈合情况、并发症、瘢痕情况及患者满意度。结果:本组12例患者创面一期植入人工真皮后均完成血管化,平均血管化时间19.16(14~21)d,术后7 d创面愈合率96.4%,术后1个月植皮区无感染、血清肿、水疱发生。术后6个月,植皮区及取皮区温哥华瘢痕评分分别为(2.16±2.36)分和(0.95±1.56)分,创面满意度评分为(4.31±0.32)分。结论:使用人工真皮结合自体刃厚皮片治疗上肢热压伤创面,操作简单,效果良好,创面外观满意度高,安全性好。

Accelerated healing of diabetic wound using artificial dermis constructed with adipose stem cells and poly（L-glutamic acid）/ chitosan scaffold

Background Diabetic wound is one of the most serious complications of diabetes mellitus. There are no significantly effective therapies for chronic non-healing diabetes ulcer so far. This study aimed to explore the feasibility of healing impaired wound using artificial dermis constructed with human adipose derived stem cells （ASCs） and poly（L-glutamic acid）/chitosan （PLGA/CS） scaffold in streptozotocin-induced diabetic mice. Methods ASCs were isolated from fresh human lipoaspirates and expanded ex vivo for three passages, and then cells were seeded onto PLGNCS scaffold to form artificial dermis. Expression of VEGF and TGFI31 by ASCs presented in artificial dermis was determined. The artificial dermis was transplanted to treat the 20 mm ~ 20 mm full-thickness cutaneous wound created on the back of diabetic mice. Wound treated with scaffold alone and without treatment, and wound in normal non-diabetic mice served as control. Results Cells growing within scaffold showed great proliferation potential, depositing abundant collagen matrix. Meanwhile, expression of VEGF and TGF-131 by seeded ASCs maintained at a consistent high level. After treated with ASC based artificial dermis, diabetic wounds exhibited significantly higher healing rate compared with wounds treated with scaffold alone or without treatment. Histological examination also demonstrated an improvement in cutaneous restoration with matrix deposition and organization. Further quantitative analysis showed that there was a significant increase in dermis thickness and collagen content on artificial dermis treated wounds. Conclusion ASC/PLGA artificial dermis can effectively accelerate diabetic wound healing by promoting angiogenic growth factors and dermal collagen synthesis.

人工真皮联合重组人酸性成纤维细胞生长因子在指端皮肤缺损的临床应用

目的皮耐克联合重组人酸性成纤维细胞生长因子(rhaFGF)治疗指端皮肤缺损的报道较少。文中旨在探讨人工真皮联合rhaFGF与单独应用人工真皮治疗指端皮肤缺损的临床效果。方法回顾性分析自2018年8月至2020年2月南京市第一医院骨科41例指端皮肤缺损患者的临床资料。按照手术方式的不同,分为联合组(人工真皮联合rhaFGF组,n=21)和单独组(单独人工真皮移植,n=20)。通过创面愈合时间、疤痕形成情况、指端感觉恢复、指端功能恢复情况来评价两组疗效。结果两组在皮温、疼痛、活动功能、痛温觉恢复方面比较,差异无统计学意义(P>0.05),而在瘢痕形成、创面愈合时间、色泽和弹性方面比较,联合组优于单独组(P<0.05)。色泽、弹性方面比较,联合组优于单独组(P<0.05)。结论rhaFGF有助于促进创面愈合,联合人工真皮治疗指端皮肤缺损的临床效果较好,值得临床推荐使用。

指动脉穿支筋膜瓣联合人工真皮Ⅰ期修复手指背侧皮肤缺损

目的:探讨指动脉穿支筋膜瓣联合人工真皮Ⅰ期修复手指中节背侧皮肤缺损的临床疗效。方法:自2019年1月至2020年5月对21例27指中节背侧皮肤缺损的患者采用指动脉穿支筋膜瓣联合人工真皮Ⅰ期进行修复,均为急诊病例,均伴有骨肌腱外露及骨膜、肌腱膜缺损。其中男11例,女10例;年龄18~66(39.00±8.01)岁;示指10指,中指9指,环指8指;皮肤缺损面积为(2.5~3.5)cm×(1.5~3.0)cm,骨肌腱外露面积(1.5~2.0)cm×(1.0~2.0)cm,伤后就诊时间1~6 h,受伤至手术时间3~8 h。观察术后创面愈合情况,并采用中华医学会手外科学会上肢部分功能评定试用标准进行临床疗效评价。结果:所有患者获得随访,时间6~12(9.66±1.05)个月。手术时间45~60 min。26指术后4~6周后创面完全愈合,1指创面感染,真皮未完全上皮化,经过创面换药,8周后达到创面愈合。所有指体外观饱满、瘢痕小,愈合创面平于周围皮肤,与周围皮肤色泽质地相近,耐磨性、柔韧性良好,手指活动度正常。按照中华医学会手外科学会上肢部分功能评定试用标准评定,本组总分72~100分;优26指,良1指。结论:指动脉穿支筋膜瓣联合人工真皮Ⅰ期修复手指中节背侧皮肤缺损简便易行,创伤小,指体外观功能恢复满意,为治疗伴有肌腱骨外露的手指皮肤缺损提供了一种有效的手术方式。

伤科黄水联合人工真皮治疗手指急性全层皮肤缺损创面自动上皮化的疗效观察

目的观察伤科黄水联合人工真皮治疗手指急性全层皮肤缺损创面自动上皮化的临床效果并探讨其作用机制。方法36例患者均给予彻底清创处理并予国产人工真皮覆盖,二期去除上层硅胶膜后,观察组予伤科黄水换药治疗,对照组予常规换药,疗程为14 d并随访2个月余,观察患者伤口疼痛、肿胀、创面愈合时间及愈合质量。结果两组患者均完成全部疗程治疗和随访,无脱落及不良事件发生。两组术前VAS评分比较,差异无统计学意义(P>0.05)。两组术后7、14 d疼痛评分与术前比较均改善,且观察组优于对照组(均P<0.05)。观察组拆除硅胶膜时间、创面愈合时间和瘢痕评分均优于对照组(均P<0.05)。两组术前肿胀情况比较,差异无统计学意义(P>0.05)。观察组术后14 d肢体肿胀消退优于对照组(P<0.05)。术后两月随访,两组患者创面愈合佳,未发生明显不良反应,创面愈合情况及中医证候疗效评价,差异无统计学意义(均P>0.05)。结论伤科黄水外敷联合人工真皮治疗手指急性全层皮肤缺损创面自动上皮化疗效好,可效促进人工真皮血管化、缩短创面愈合时间,同时提高患者治疗体验,减轻瘢痕形成,提高愈合质量。

In-situ constructed polymer/alloy composite with high ionic conductivity as an artificial solid electrolyte interphase to stabilize lithium metal anode

Lithium(Li)metal is regarded as the best anode material for lithium metal batteries(LMBs)due to its high theoretical specific capacity and low redox potential.However,the notorious dendrites growth and extreme instability of the solid electrolyte interphase(SEI)layers have severely retarded the commercialization process of LMBs.Herein,a double-layered polymer/alloy composite artificial SEI composed of a robust poly(1,3-dioxolane)(PDOL)protective layer,Sn and LiCl nanoparticles,denoted as PDOL@Sn-LiCl,is fabricated by the combination of in-situ substitution and polymerization processes on the surface of Li metal anode.The lithiophilic Sn-LiCl multiphase can supply plenty of Li-ion transport channels,contributing to the homogeneous nucleation and dense accumulation of Li metal.The mechanically tough PDOL layer can maintain the stability and compact structure of the inorganic layer in the long-term cycling,and suppress the volume fluctuation and dendrites formation of the Li metal anode.As a result,the symmetrical cell under the double-layered artificial SEI protection shows excellent cycling stability of 300 h at 5.0 mA·cm^(−2)for 1 mAh·cm^(−2).Notably,the Li||LiFePO_(4)full cell also exhibits enhanced capacity retention of 150.1 mAh·g^(−1)after 600 cycles at 1.0 C.Additionally,the protected Li foil can effectively resist the air and water corrosion,signifying the safe operation of Li metal in practical applications.This present finding proposed a different tactic to achieve safe and dendrite-free Li metal anodes with excellent cycling stability.

人工真皮在皮肤恶性肿瘤切除术后创面修复中的临床价值

目的探讨人工真皮在皮肤恶性肿瘤切除术后创面修复的临床疗效。方法收集中山大学附属第五医院住院的难以用皮瓣修复或基础疾病较多的皮肤恶性肿瘤患者25例,包括基底细胞癌16例、皮肤鳞状细胞癌7例、隆突性皮肤纤维肉瘤2例,均采用Mohs显微外科手术切除肿瘤,术后创面使用人工真皮覆盖,观察术后恢复效果。结果25例患者均完成修复。23例(92.00%)患者术后1~2个月创面愈合,轻度疤痕增生;3个月后所有患者伤口都愈合。半年后随访,疤痕轻度增生。结论人工真皮能有效覆盖皮肤恶性肿瘤切除术后创面,操作简单;创面愈合后仅轻度疤痕增生,总体效果较好。

双层人工真皮治疗手部皮肤缺损伴肌腱、骨质外露

目的 探讨双层人工真皮修复手部皮肤缺损伴肌腱、骨质外露的疗效。方法 采用双层人工真皮治疗24例手部皮肤缺损伴肌腱、骨质外露患者,术后根据创面缺损大小与位置选择是否再行中厚自体皮片移植。结果 患者均获得随访,时间2~12个月。术后3周,人工真皮全部获得血管化,并形成了淡红色类真皮样组织。11例未行自体皮片移植,术后20~37 d创面自然上皮化爬行愈合。13例采用中厚自体皮片移植,术后2周创面愈合良好,外形美观,质地柔软有弹性。末次随访时,24例患者指间关节及掌指关节活动均恢复正常,患者对治疗效果均满意。结论 双层人工真皮是修复手部皮肤缺损伴肌腱、骨质外露的良好方法,手术操作简便,创伤小,较小的缺损面积无需行游离皮片移植,避免了额外手术创伤及风险,能够较好地恢复患肢(指)外形及功能。