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《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

卷:

期数:

2024年4期

页码:

37-41

栏目:

出版日期:

2024-04-10

文章信息/Info

Title:

A Comparative Study on the Effi cacy of Different Artifi cial Dermis Combined with Autologous Blade-thick Skin Transplantation in Repairing Wounds with Bone and Tendon Exposure

文章编号:

1008-6455（2024）04-0037-05

作者:

蒋 丹; 刘亚兰; 李 胜; 朱澳博

(资阳市中心医院烧伤整形科 四川 资阳 641300 )

Author(s):

JIANG Dan;  LIU Yalan;  LI Sheng;  ZHU Aobo

(Department of Burn and Plastic Surgery, Ziyang Central Hospital, Ziyang 641300, Sichuan, China)

关键词:

人工真皮; 自体刃厚皮片; 移植; 骨质肌腱外露; 创面

Keywords:

artifi cial dermis;  autogenous blade-thick skin;  transplantation;  bone and tendon exposure;  wound

分类号:

R622

文献标志码:

A

摘要:

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。

Abstract:

Objective The aim of this study was to investigate the influence of different artificial dermis combined with autologous blade-thick skin grafts on transplantation eff ects and aesthetic eff ects in patients with wounds with bone and tendon exposure. Methods The general clinical data of 60 patients with wounds with bone and tendon exposure who underwent wound repair in the hospital from May 2019 to May 2022 were analyzed retrospectively.Among them, 37 patients treated with double layer artifi cial leather for quick healing combined with autologous blade-thick skin grafts were defi ned as the control group, and 23 patients treated with domestic double-layer artificial dermis combined with autologous blade-thick skin grafts were defi ned as the study group.Graft eff ect and survival of skin grafts were compared between the two groups. Results There was no signifi cant diff erence in the frequency of skin grafting, the incidence of complications, and the survival rate of skin grafts between the two groups (P ＞0.05). The interval time of skin grafting in the study group was longer than that in the control group (P＜0.05). There were no signifi cant diff erences in the levels of interleukin-1, tumor necrosis factor, interleukin-12, and interferon-γ between the two groups at 3, 7, and 14 days after treatment (P ＞0.05). There were no signifi cant diff erences in the levels of transforming growth factor-β1 and vascular endothelial growth factor between the two groups 3 days after treatment (P ＞0.05), but the levels of transforming growth factor-β1 and vascular endothelial growth factor in the study group were lower than those in the control group 7 and 14 days after treatment (P＜0.05). At 3 months after treatment, there was no signifi cant difference in Vancouver Scar Scale score between the two groups (P ＞0.05). Conclusion Domestic double-layer artificial dermis and double layer artifi cial leather for quick healing respectively combined with autologous blade-thick skin grafts can achieve equivalent eff ects in repairing wounds with bone and tendon exposure. However, the interval between grafts of the former is longer, which may be related to the slightly lower level of growth factor in wound tissues.

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更新日期/Last Update: 2024-04-10