双层人工真皮修复手足部肌腱及骨外露创面疗效分析OA
Efficacy Analysis of Double-layer Artificial Dermis in Repairing Hand and Feet Tendon and Bone Exposure Wounds
目的:探究双层人工真皮修复手足部肌腱及骨外露创面的疗效.方法:选取2020年6月-2023年10月河北中石油中心医院收治的80例手足部肌腱及骨外露患者为研究对象,按随机数字表法分为对照组和观察组,各40例.对照组采用皮能快愈敷料结合自体刃厚皮片移植治疗,观察组采用双层人工真皮结合自体刃厚皮片移植治疗,两组均观察至术后6个月.统计比较两组术后14 d植皮成活情况、治疗情况,术后3d及术后14 d血清炎性因子水平、创面生长因子水平及凋亡基因表达情况,并统计比较两组术后6个月的创面修复美观度.结果:术后14d,观察组植皮成活情况优于对照组(P＜0.05);两组植皮次数和住院时间比较,差异无统计学意义(P＞0.05);观察组移植间隔时间长于对照组(P＜0.05);术后14d,两组血清TNF-α、IFN-γ水平均较术后3d降低(P＜0.05),但两组组间比较差异无统计学意义(P＞0.05);术后14 d,两组VEGF、TGF-β1水平均较术后3d升高,但观察组低于对照组(P＜0.05);两组创面p53、Bax、Caspase-3水平均降低,但组间比较差异无统计学意义(P＞0.05);术后6个月,观察组VSS各方面评分及总分均低于对照组(P＜0.05).结论:双层人工真皮能够有效促进手足部肌腱及骨外露患者创面愈合,稳定体内炎性状态及创口凋亡基因表达,减少瘢痕产生的同时提高创面修复美观度,改善植皮成活情况,但是存在移植间隔时间长的弊端.
Objective To explore the effect of double-layer artificial dermis in repairing wounds with tendon and bone exposure in hands and feet.Methods A total of 80 patients with hand and foot tendon and bone exposure admitted to Hebei China Petroleum Central Hospital from June 2020 to October 2023 were selected as the research objects.According to the random number table method,they were divided into the control group and the observation group,with 40 cases in each group.The control group was treated with skin healing dressing combined with autologous thick skin graft,while the observation group was treated with double-layer artificial dermis combined with autologous thick skin graft.The survival and treatment of skin grafting on the 14th day after operation,the levels of serum inflammatory factors and wound growth factors on the 3rd and 14th day after operation,and the expression of apoptotic genes on the 3rd and 14th day after operation were statistically compared between the two groups.The wound repair aesthetics of the two groups was statistically compared 6 months after operation.Results At 14 days after operation,the survival of skin grafting in the observation group was better than that in the control group(P＜0.05).There was no significant difference in the number of skin grafting and hospital stay between the two groups(P＞0.05).The transplantation interval time in the observation group was longer than that in the control group(P＜0.05).At 14 days after operation,the serum levels of TNF-α and IFN-γ in the two groups were lower than those at 3 days after operation(P＜0.05),but there was no significant difference between the two groups(P＞0.05).At 14 days after operation,the levels of VEGF and TGF-β1 in the two groups were higher than those at 3 days after operation,but those in the observation group were lower than those in the control group(P＜0.05).The levels of p53,Bax,and Caspase-3 in the two groups were decreased,but there was no significant difference between the two groups(P＞0.05).At 6 months after operation,the scores of all aspects and total score of VSS in the observation group were lower than those in the control group(P＜0.05).Conclusion Double-layer artificial dermis could effectively promote the wound healing of patients with tendon and bone exposure in hands and feet,stabilize the inflammatory state in vivo and the expression of wound apoptosis gene,reduce scar formation,improve the aesthetics of wound repair and improve the survival of skin grafting,but it had the disadvantage of long transplant interval.
蔺利剑;王旭文;苏伟海;赵龙刚;邓凯;李雯
河北中石油中心医院整形手外烧伤科 河北廊坊 065000河北中石油中心医院整形手外烧伤科 河北廊坊 065000河北中石油中心医院整形手外烧伤科 河北廊坊 065000河北中石油中心医院整形手外烧伤科 河北廊坊 065000河北中石油中心医院整形手外烧伤科 河北廊坊 065000
医药卫生
手足部肌腱外露骨外露创面双层人工真皮皮片移植
hand and foottendon exposurebone exposurewounddouble-layer artificial dermisskin graft
《中国美容医学》 2026 (2)
5-9,5
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