Artificial dermis combined with autologous thin skin transplantation for repair of lower limb traumatic wound with bone exposure

doi:10.3877/cma.j.issn.1673-9450.2016.03.014

Abstract

Abstract:

Objective

To summarize and analyze the clinical effect of artificial dermis combined with autologous thin skin transplantation for repair of lower limb traumatic wound with bone exposure.

Methods

Elven lower limb traumatic wound with bone exposure patients were analyzed retrospectively in Department of Burns, Wuhan Third Hospital & Tongren Hospital of Wuhan University from June 2010 to June 2013. Of the 11 patients, 10 were male, 1 was female, aged from 23 to 76 years, were treated with expanson of debridement and artificial dermis in the first stage and autologous thin split thickness skin grafts in the second stage. Treatment effect was evaluated through the recovery condition of traumatic wound and skin transplantation wound.

Results

Skin regeneration time after skin donor site of 11 patients were(15.5±2.5)d, the time of second stage skin grafting operation after first stage operation were (18.5±2.2)d. Eleven patients with skin graft were intact, good healing, smooth appearance, skin color was slightly deeper than normal skin.There were 2 patients with very slight scar, 1 patients with mild scar and 8 patients without obvious scar formation.Patients were satisfied with the overall effect.

Conclusion

Artificial dermis combined with autologous thin skin transplantation is effective to repair lower limb traumatic wound with bone exposure.

Key words: Skin transplantation, Artificial dermis, Bone exposure

Wenwei Huang, Weiguo Xie, Hongxia Xia, Wei Wang, Weidong Zhang. Artificial dermis combined with autologous thin skin transplantation for repair of lower limb traumatic wound with bone exposure[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2016, 11(03): 225-228.

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Figures/Tables 3

References 9

1	田彭，周业平，张国安．人工真皮修复软组织缺损20例[J]．中国组织工程研究与临床康复，2009，13(53)：10573-10576.
2	陈辉，李建宁．应用人工真皮联合自体薄层皮片移植修复深度皮肤软组织缺损11例[J]．中国组织工程研究与临床康复，2008，12(36)：7148-7150.
3	周业平，于东宁，张国安．人工真皮治疗创伤后下肢软组织缺损的初步研究[J/CD]．中华损伤与修复杂志：电子版，2009，4(1)：20-24.
4	Suzuki S, Kawai K, Ashoori F, et al. Long－term follow－up study of artificial dermis composed of outer silicone layer and inner collagen sponge[J]. Br J Plast Surg, 2000, 53(8): 659-666.
5	Koga Y, Komuro Y, Yamato M, et al.Recovery course of ful1－thickness skin defects with exposed bone: an evaluation by a quantitative examination of new blood vessels[J]. J Surg Res, 2007, 137(1): 30-37.
6	Yannas IV, Burke JF. Design of an artificial skin IBasic design Principles[J]. J Biomed Mater Res, 1980, 14(1): 65-81.
7	Bargues L, Prat M, Leclerc T, et al. Present and future of cell therapy in burns[J]. Pathol Biol, 2011, 59(3): 49-56.
8	魏刚强，孙少艾，徐刚．烧伤创面外用人工皮肤的研究与临床应用[J]．中国组织工程研究与临床康复，2008，12(19)：3725-3728.
9	Muneuchi G, Suzuki S, Moriue T, et al. Combined treatment using artificial dermis and basic fibroblast growth factor ( bFGI ) for tractable fingertip ulcers caused by atypical burn injuries[J]. Burns, 2005, 31(4): 514-517.

序号	性别	年龄(岁)	受伤部位	创面面积(cm²，±s)	骨外露面积(cm²，±s)
1	男	28	右侧胫骨	171.0	90.0
2	男	25	右侧足跟	12.0	3.0
3	女	54	左侧足背	30.0	7.5
4	男	23	左侧胫骨	90.0	24.0
5	男	33	右侧胫骨	48.0	7.5
6	男	47	左侧足趾	6.0	4.0
7	男	45	右足足趾	5.0	3.0
8	男	41	右侧足踝及足跟	12.0	6.0
9	男	52	左侧足背	15.0	7.0
10	男	76	右足足趾	8.0	3.0
11	男	44	右足足趾	6.0	2.0

序号	性别	年龄(岁)	受伤部位	创面面积(cm²，±s)	骨外露面积(cm²，±s)
1	男	28	右侧胫骨	171.0	90.0
2	男	25	右侧足跟	12.0	3.0
3	女	54	左侧足背	30.0	7.5
4	男	23	左侧胫骨	90.0	24.0
5	男	33	右侧胫骨	48.0	7.5
6	男	47	左侧足趾	6.0	4.0
7	男	45	右足足趾	5.0	3.0
8	男	41	右侧足踝及足跟	12.0	6.0
9	男	52	左侧足背	15.0	7.0
10	男	76	右足足趾	8.0	3.0
11	男	44	右足足趾	6.0	2.0

序号	供皮区取皮后表皮重新覆盖时间(d)	二期植皮距离一期手术后时间(d)	创面修复情况	供皮区瘢痕情况
1	22	24	良好	轻度瘢痕
2	14	16	良好	无瘢痕
3	16	18	良好	极轻度瘢痕
4	17	19	良好	无瘢痕
5	16	20	良好	无瘢痕
6	15	18	良好	无瘢痕
7	13	17	良好	无瘢痕
8	14	18	良好	无瘢痕
9	15	19	良好	极轻度瘢痕
10	14	18	良好	无瘢痕
11	14	16	良好	无瘢痕

序号	供皮区取皮后表皮重新覆盖时间(d)	二期植皮距离一期手术后时间(d)	创面修复情况	供皮区瘢痕情况
1	22	24	良好	轻度瘢痕
2	14	16	良好	无瘢痕
3	16	18	良好	极轻度瘢痕
4	17	19	良好	无瘢痕
5	16	20	良好	无瘢痕
6	15	18	良好	无瘢痕
7	13	17	良好	无瘢痕
8	14	18	良好	无瘢痕
9	15	19	良好	极轻度瘢痕
10	14	18	良好	无瘢痕
11	14	16	良好	无瘢痕

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