中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2014年
1期
36-38
,共3页
李士%宋永焕%周飞亚%陈一衡%陈星隆%李志杰%高伟阳
李士%宋永煥%週飛亞%陳一衡%陳星隆%李誌傑%高偉暘
리사%송영환%주비아%진일형%진성륭%리지걸%고위양
软组织损伤%皮肤移植术%全厚皮片
軟組織損傷%皮膚移植術%全厚皮片
연조직손상%피부이식술%전후피편
Soft tissue injury%Skin grafting%Full thinkness skin
目的 研究并评价儿童足踝部皮肤软组组缺损伴软骨或骨外露使用人工真皮(Pelnac)联合自体全厚皮移植的治疗效果.方法 回顾分析2011年1月至2013年2月间收治的13例足踝部皮肤软组织缺损伴骨或软骨外露患儿,男9例,女4例,年龄3～9岁,平均5.2岁.软组织缺损面积12～62 cm2,平均35.5 cm2,骨或软骨外露面积0.7～6.0cm2,平均3.0cm2.一期清创行VSD覆盖,二期采用Pelnac覆盖创面,2～3周后在Pelnac表面移植自体全厚皮肤修复创面.结果 所有患儿所植皮肤全部存活,创面得到了有效的修复.移植皮肤未见瘢痕增生挛缩,无明显色素沉着,足踝部外观恢复满意,下肢负重、行走功能正常.供区仅遗留线性瘢痕,部位隐蔽不易察觉.结论 对于足踝部皮肤软组织缺损伴骨或软骨外露的儿童患者,采用Pelnac结合自体腹部全厚皮复合移植可取的满意效果.避免了传统皮瓣移植手术所致的供区损伤大、皮瓣外观欠佳等缺点.
目的 研究併評價兒童足踝部皮膚軟組組缺損伴軟骨或骨外露使用人工真皮(Pelnac)聯閤自體全厚皮移植的治療效果.方法 迴顧分析2011年1月至2013年2月間收治的13例足踝部皮膚軟組織缺損伴骨或軟骨外露患兒,男9例,女4例,年齡3～9歲,平均5.2歲.軟組織缺損麵積12～62 cm2,平均35.5 cm2,骨或軟骨外露麵積0.7～6.0cm2,平均3.0cm2.一期清創行VSD覆蓋,二期採用Pelnac覆蓋創麵,2～3週後在Pelnac錶麵移植自體全厚皮膚脩複創麵.結果 所有患兒所植皮膚全部存活,創麵得到瞭有效的脩複.移植皮膚未見瘢痕增生攣縮,無明顯色素沉著,足踝部外觀恢複滿意,下肢負重、行走功能正常.供區僅遺留線性瘢痕,部位隱蔽不易察覺.結論 對于足踝部皮膚軟組織缺損伴骨或軟骨外露的兒童患者,採用Pelnac結閤自體腹部全厚皮複閤移植可取的滿意效果.避免瞭傳統皮瓣移植手術所緻的供區損傷大、皮瓣外觀欠佳等缺點.
목적 연구병평개인동족과부피부연조조결손반연골혹골외로사용인공진피(Pelnac)연합자체전후피이식적치료효과.방법 회고분석2011년1월지2013년2월간수치적13례족과부피부연조직결손반골혹연골외로환인,남9례,녀4례,년령3～9세,평균5.2세.연조직결손면적12～62 cm2,평균35.5 cm2,골혹연골외로면적0.7～6.0cm2,평균3.0cm2.일기청창행VSD복개,이기채용Pelnac복개창면,2～3주후재Pelnac표면이식자체전후피부수복창면.결과 소유환인소식피부전부존활,창면득도료유효적수복.이식피부미견반흔증생련축,무명현색소침착,족과부외관회복만의,하지부중、행주공능정상.공구부유류선성반흔,부위은폐불역찰각.결론 대우족과부피부연조직결손반골혹연골외로적인동환자,채용Pelnac결합자체복부전후피복합이식가취적만의효과.피면료전통피판이식수술소치적공구손상대、피판외관흠가등결점.
Objective To evaluate the clinical outcomes of artificial dermis(Pelnac) combined with full-thickness skin graft in treating skin and soft tissue defects of foot and ankle in children.Methods From January 2011 to Feburary 2013,13 children (9 boys,4 girls) underwent transplantation of artificial dermis with full-thinkness abdomen or groin skin were retrospectively reviewed.The average age was 5.2 years old,ranged from 3 to 9 years.All of the soft tissue defects were caused by trauma.The area of skin and soft tissue defects ranged from 12 cm2 to 62 cm2.The area of bone or cartilage exposure ranged from 0.7 cm2 to 6.0 cm2.Initial debridement and vacuum sealing drainage(VSD) coverage were followed by Pelnac covering if the wounds did not infected after several days Full-thickness abdomen or groin skin was transplanted and the exposed bone or cartilage was covered by dermis-like tissues when the local granulation tissue grew well 2-3 weeks later.Results All cases had good coverage of the wounds and grafts survival.One case had skin defects about 0.5 cm × 0.5 cm on the surface of cartilage,and the defect was covered only by dressing.All the cases were followed up from 4 months to 14 months.The appearance of the recipient site is good without obvious scar in all cases.The donor skin heals well with linear scar.Conclusions Artificial dermis combined with full thickness skin graft is effective to repair skin and soft tissue defects associated with bone or cartilage exposure of foot and ankle.It can also avoid the poor appearance of the conventional flap and the large injury to the donor site.
