Volume 39 Issue 12
Dec.  2023
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Yang HN,Liang Y,Han DW,et al.Effects of artificial dermis combined with autologous skin in repairing the wounds with exposed bone and/or tendon in fingers of children after electric burns[J].Chin J Burns Wounds,2023,39(12):1180-1184.DOI: 10.3760/cma.j.cn501225-20231101-00168.
Citation: Yang HN,Liang Y,Han DW,et al.Effects of artificial dermis combined with autologous skin in repairing the wounds with exposed bone and/or tendon in fingers of children after electric burns[J].Chin J Burns Wounds,2023,39(12):1180-1184.DOI: 10.3760/cma.j.cn501225-20231101-00168.

Effects of artificial dermis combined with autologous skin in repairing the wounds with exposed bone and/or tendon in fingers of children after electric burns

doi: 10.3760/cma.j.cn501225-20231101-00168
Funds:

Joint Construction Project of Henan Medical Science and Technology Research Plan LHGJ20191002, LHGJ20210714, LHGJ20210715

More Information
  • Corresponding author: Wei Ying, Email: wyben2012@163.com
  • Received Date: 2023-11-01
    Available Online: 2023-12-19
  •   Objective   To explore the effects of artificial dermis combined with autologous skin in repairing the wounds with exposed bone and/or tendon in fingers of children after electric burns.   Methods   A retrospective observational study was conducted. From January 2017 to December 2022, 14 children with bone and/or tendon exposed wounds in fingers after electric burns who met the inclusion criteria were admitted to Zhengzhou First People's Hospital, including 9 males and 5 females, aged 2 to 11 years. A total of 38 fingers were affected, with 1 wound per finger. After debridement, artificial dermal coverage combined with vacuum sealing drainage was performed in all the wounds in the first stage, with wound area of 2.0 cm×1.0 cm-4.5 cm×2.5 cm after debridement. The second stage surgery was performed to close the wound with autologous thin intermediate thickness skin graft. Then the children were told to perform functional rehabilitation exercise as early as possible. The survival of autologous skin graft was observed at the 7 th day after the second stage surgery. The wound healing time was recorded. After 12 months of follow-up, the Vancouver scar scale was used to evaluate the scar hyperplasia at the skin grafting site of the affected finger; the total action mobility (TAM) of the affected finger joint was measured for evaluating the functional recovery of the affected finger; a self-made efficacy satisfaction rating table was used to investigate the parents' satisfaction with the curative effect of the children.   Results   At the 7 th day after the second stage surgery, all the children had good survival of autologous skin grafts. The wound healing time was (24.1±2.7) d. After 12 months of follow-up, the scar score at the skin grafting site of the affected finger was 5.2±2.4; the TAM of the affected finger joint was (177±40)°; the functional assessment was good in 12 fingers, medium in 23 fingers, and poor in 3 fingers; the parents' satisfaction with the curative effect of the children in the survey was very satisfied in 10 cases, satisfied in 3 cases, and dissatisfied in 1 case.   Conclusions   The combination of artificial dermis and autologous thin intermediate thickness skin graft is an alternative surgical method that can effectively repair the bone and/or tendon exposed wounds in fingers of children after electric burns. After wound healing, the scars are slight, the finger function is well recovered, and the parents of the children are highly satisfied with the curative effect of the children, which is worthy of clinical promotion.

     

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  • [1]
    GuptaP,TawarRS,MalviyaM.Groin flap in paediatric age group to salvage hand after electric contact burn: challenges and experience[J].J Clin Diagn Res,2017,11(8):PC01-PC03. DOI: 10.7860/JCDR/2017/29124.10332.
    [2]
    DingHR, HuangMM, LiDH, et al. Epidemiology of electrical burns: a 10-year retrospective analysis of 376 cases at a burn centre in South China[J]. J Int Med Res, 2020,48(3):300060519891325. DOI: 10.1177/0300060519891325.
    [3]
    KymD,SeoDK,HurGY,et al. Epidemiology of electrical injury: differences between low- and high-voltage electrical injuries during a 7-year study period in South Korea[J].Scand J Surg,2015,104(2):108-114.DOI: 10.1177/1457496914534209.
    [4]
    中华医学会烧伤外科学分会,《中华烧伤杂志》编辑委员会.负压封闭引流技术在烧伤外科应用的全国专家共识(2017版)[J].中华烧伤杂志,2017,33(3):129-135.DOI: 10.3760/cma.j.issn.1009-2587.2017.03.001.
    [5]
    王成, 陈欣, 沈余明, 等. 人工真皮联合自体皮片修复创伤后骨和/或肌腱外露创面的临床研究[J].中国医刊,2020,55(12):1334-1337. DOI: 10.3969/j.issn.1008-1070.2020.12.018.
    [6]
    周雅静,侯玉森,李冬海,等.人工真皮联合自体刃厚头皮在修复儿童烧伤后肢体关节瘢痕挛缩中的临床应用效果[J/CD].中华损伤与修复杂志(电子版),2021,16(4):322-325. DOI: 10.3877/cma.j.issn.1673-9450.2021.04.007.
    [7]
    胡大海,易南,朱雄翔.实用烧伤康复治疗学[M].北京:人民卫生出版社,2015.
    [8]
    狄海萍,母心灵,史继静,等.人工真皮联合刃厚皮修复手足骨骼与肌腱外露创面效果的前瞻性随机对照研究[J].中华烧伤杂志,2021,37(12):1130-1136.DOI: 10.3760/cma.j.cn501120-20210325-00103.
    [9]
    赵海洋,王洪涛,周琴,等.应用低温热塑板结合特制腹带固定修复17例患儿手部深度电烧伤创面的腹部带蒂皮瓣[J].中华烧伤杂志,2019,35(11):819-820.DOI: 10.3760/cma.j.issn.1009-2587.2019.11.010.
    [10]
    杨焕友,王斌,李瑞国,等.吻合血管的第二掌背动脉皮瓣修复手指掌侧皮肤伴双侧指固有神经、动脉缺损[J].中华手外科杂志,2021,37(1):10-12.DOI: 10.3760/cma.j.cn311653-20200303-00094.
    [11]
    戚建武,孙斌鸿,刘林海,等.游离髂腹股沟皮瓣修复手部皮肤软组织缺损[J].中华手外科杂志,2019,35(1):12-15. DOI: 10.3760/cma.j.issn.1005-054X.2019.01.006.
    [12]
    杜伟力,胡骁骅,沈余明,等.逆行缝匠肌肌皮瓣修复小腿截肢残端创面[J].骨科临床与研究杂志,2018,3(4):241-245.DOI: 10.19548/j.2096-269x.2018.04.011.
    [13]
    赵黎君,周琴,邹小梅.鼠神经生长因子联合腹部超薄皮瓣修复手部深度电烧伤创面[J].中国美容医学,2022,31(10):31-34.DOI: 10.15909/j.cnki.cn61-1347/r.005286.
    [14]
    邱学文,王甲汉.双层人工皮对猪急性皮肤缺损创面的疗效评价及作用机制[J].南方医科大学学报,2018,38(3):363-368.DOI: 10.3969/j.issn.1673-4254.2018.03.20.
    [15]
    陈欣,副岛一孝,野崎斡弘,等.成纤维细胞移植促进人工真皮内血管新生的研究[J].中国修复重建外科杂志, 2004, 18(3):205-208.
    [16]
    KaurA,MidhaS,GiriS,et al.Functional skin grafts:where biomaterials meet stem cells[J]. Stem Cell Int,2019,2019:1286054.DOI: 10.1155/2019/1286054.
    [17]
    SavojiH, GodauB, HassaniMS, et al. Skin tissue substitutes and biomaterial risk assessment and testing[J]. Front Bioeng Biotechnol, 2018,6:86. DOI: 10.3389/fbioe.2018.00086.
    [18]
    孙建平, 王永军, 张水良, 等. 人工真皮复合自体刃厚皮片移植修复烧伤后骨外露创面六例[J].中华烧伤杂志,2013,29(4):404-405. DOI: 10.3760/cma.j.issn.1009-2587.2013.04.025.
    [19]
    王永胜,邱健钊,李军,等.人工真皮覆盖修复手足小面积创面的效果[J].临床骨科杂志,2017,20(1):64-66.DOI: 10.3969/j.issn.1008-0287.2017.01.028.
    [20]
    TullioV,CervettiO,RoanaJ,et al.Advances in microbiology, infectious diseases and public health: refractory trichophyton rubrum infections in Turin, Italy: a problem still present[J].Adv Exp Med Biol,2016,901:17-23.DOI: 10.1007/5584_2015_5012.
    [21]
    KrasowskiG, JunkaA, PalecznyJ, et al. In vitro evaluation of polihexanide, octenidine and NaClO/HClO-based antiseptics against biofilm formed by wound pathogens[J].Membranes (Basel),2021,11(1):62.DOI: 10.3390/membranes11010062.
    [22]
    TahirS, MaloneM, HuHH, et al. The effect of negative pressure wound therapy with and without instillation on mature biofilms in vitro[J]. Materials (Basel), 2018,11(5):811. DOI: 10.3390/ma11050811.
    [23]
    刘坡,柯昌能,舒斌,等.负压伤口疗法对老年糖尿病溃疡创面表皮干细胞增殖的影响[J/CD].中华损伤与修复杂志(电子版),2017,12(6):432-436.DOI: 10.3877/cma.j.issn.1673-9450.2017.06.006.
    [24]
    杨敏烈,周小金,朱宇刚,等.不同模式持续负压伤口疗法对下肢静脉性溃疡创面的临床疗效及其影响因素[J].中华烧伤杂志,2020,36(12):1149-1158. DOI: 10.3760/cma.j.cn501120-20200316-00173.
    [25]
    Markiewicz-GospodarekA, KoziołM, TobiaszM, et al. Burn wound healing: clinical complications, medical care, treatment, and dressing types: the current state of knowledge for clinical practice[J]. Int J Environ Res Public Health, 2022,19(3):1338. DOI: 10.3390/ijerph19031338.
    [26]
    曹宗申,明立功,明朝戈,等.切开复位克氏针或注射器针头内固定治疗儿童拇指指骨颈陈旧性骨折[J].中医正骨,2014,26(10):70-71.
    [27]
    陈锦河, 郭毅斌, 郑健生, 等. 十字形中厚皮片移植修复大腿残端巨大创面四例[J].中华烧伤杂志,2013,29(2):215-216. DOI: 10.3760/cma.j.issn.1009-2587.2013.02.033.
    [28]
    李智明,黄远发,方云德,等.背部供皮区在大面积烧伤后期整复中的应用[J].组织工程与重建外科杂志,2012,8(6):336-337.DOI: 10.3969/j.issn.1673-0364.2012.06.010.
    [29]
    FigusA, Leon-VillapalosJ, PhilpB, et al. Severe multiple extensive postburn contractures: a simultaneous approach with total scar tissue excision and resurfacing with dermal regeneration template[J]. J Burn Care Res, 2007,28(6):913-917. DOI: 10.1097/BCR.0b013e318159eb8c.
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