Li Minxiong, Ma Jun, Zheng Zijun, et al. Clinical effect of bi-layered artificial dermis and autologous skin graft in repairing bone and/or tendon exposed wounds[J]. Chin j Burns, 2020, 36(3): 179-186. Doi: 10.3760/cma.j.cn501120-20191119-00437
Citation: Li Minxiong, Ma Jun, Zheng Zijun, et al. Clinical effect of bi-layered artificial dermis and autologous skin graft in repairing bone and/or tendon exposed wounds[J]. Chin j Burns, 2020, 36(3): 179-186. Doi: 10.3760/cma.j.cn501120-20191119-00437

Clinical effect of bi-layered artificial dermis and autologous skin graft in repairing bone and/or tendon exposed wounds

doi: 10.3760/cma.j.cn501120-20191119-00437
  • Received Date: 2019-11-19
    Available Online: 2021-10-28
  • Publish Date: 2020-03-20
  • Objective To explore the clinical effect of bi-layered artificial dermis combined with autologous skin graft in the repair of wounds with exposed bone and/or tendon. Methods The medical records of 25 patients (aged 3 to 79 years, including 21 males and 4 females) with bone and/or tendon exposed wounds caused by various reasons, admitted to Nanfang Hospital of Southern Medical University from May 2014 to December 2018 were analyzed retrospectively. Of the 25 patients, 7 patients had exposed bone only, 13 patients had exposed tendon only, and 5 patients had exposure of both bone and tendon. The total wound area was 78.0 (53.4, 103.2) cm2. The widths of bone exposure and tendon exposure were 3.2 (3.0, 3.6) cm and 2.0 (1.7, 2.4) cm, respectively. All wounds were implanted with bi-layered artificial dermis in the first stage after thorough wound debridement. After 2 to 3 weeks of vascularization of artificial dermis, autologous thin-to-medium-thickness skins or split-thickness skins were grafted to repair the wounds in the second stage. The vascularization of artificial dermis and its time, whether or not producing hematoma, the skin graft survival rate on day 7 post autologous skin grafting, whether or not repeating skin grafting, and the time of complete wound healing were observed and recorded. The patients were further followed up and observed for 3 or more months after discharge. Results The vascularization of artificial dermis was achieved in 24 patients after the first transplantation with vascularization time being 11-21 (16±4) days. No hematoma was observed in the transplanted artificial dermis. Failed vascularization of grafted artificial dermis was observed in one patient who was later treated with negative pressure drainage and skin grafting alone, and was discharged with wound healing. The skin graft survival rate on day 7 post autologous skin grafting was 92.2%-100.0% ( (99.3±1.3)%), with the remaining wound areas recovered later by themselves or healed by dressing changes without repeated skin grafting. The complete wound healing time was 7-19 (11.9±2.8) days after autologous skin grafting. The patients were followed up for 3 to 60 months after discharge. Except for the pigmentation in skin graft area, the skin grafts survived well, being soft in texture and with no repeated ulceration, obvious hypertrophic scar, or contracture deformity. Conclusions Artificial dermis combined with autologous skin grafting can effectively repair wounds with bone and/or tendon exposure, providing a repair strategy for this type of wounds.

     

  • Relative Articles

    [1]He Lin, Wang Rui, Zhu Chan, Yu Xueyuan, He Youcheng, Zhou Lin, Zhang Zhuo, Shu Maoguo. Clinical effects of flaps or myocutaneous flaps transplantation after titanium mesh-retaining debridement in repairing the wounds with exposed titanium mesh after cranioplasty[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2024, 40(3): 273-280. doi: 10.3760/cma.j.cn501225-20231031-00163
    [2]Wu Jiamin, Yang Hao, Li Qi, Luo Taofan, Yang Po, Huang Weichen. Clinical efficacy of local injection of platelet-rich plasma combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(9): 849-856. doi: 10.3760/cma.j.cn501225-20230420-00134
    [3]Yang Huanna, Liang Yan, Han Dawei, Liu Lei, Xie Jiangfan, Tian Shemin, Xia Chengde, Wei Ying. 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]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(12): 1180-1184. doi: 10.3760/cma.j.cn501225-20231101-00168
    [4]Rong Xiangke, Wang Kai, Wang Tong, Yang Jizhong, Ding Jianke, Dang Juanli, Yu Zhou, Yi Chenggang. Explorative study of the immobilizing effect of full-thickness skin subcutaneous grafting on allogeneic full-thickness skin graft in rats[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2021, 37(10): 987-989. doi: 10.3760/cma.j.cn501120-20200801-00365
    [5]Di Haiping, Mu Xinling, Shi Jijing, Xue Jidong, Liu Lei, Guo Haina, Xing Peipeng, Xia Chengde. A prospective randomized controlled study of the effectiveness of artificial dermis combined with split-thickness skin for repairing wounds with bone and tendon exposure in hands and feet[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2021, 37(12): 1130-1136. doi: 10.3760/cma.j.cn501120-20210325-00103
    [6]Kang Kun, Shao Yang, Song Guodong. Research status and prospect on autologous tissue-engineered skin as permanent graft[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2020, 36(10): 971-974. doi: 10.3760/cma.j.cn501120-20200204-00043
    [8]Jin Jian, Zhou Hao, Cui Zhenci, Wang Li, Luo Pengfei, Ji Shizhao, Hu Xiaoyan, Ma Bing, Wang Guangyi, Zhu Shihui, Xia Zhaofan. Antiseptic effect of compound lysostaphin disinfectant and its preventive effect on infection of artificial dermis after graft on full-thickness skin defect wound in rats[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2018, 34(4): 225-232. doi: 10.3760/cma.j.issn.1009-2587.2018.04.007
    [9]Huang Hua, Yan Rongshuai, Liu Meixi, Zhou Junyi, Tan Jianglin, Zhang Xiaorong, Hu Xiaohong, Huang Yong, He Weifeng, Wu Jun, Luo Gaoxing. Role of dentritic epidermal T lymphocytes in immune rejection of skin allograft in mice and its mechanism[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2015, 31(2): 125-129. doi: 10.3760/cma.j.issn.1009-2587.2015.02.012
    [11]Chen Xin, Wang Hao, Dai Yundong, Zhang Cong, Wang Cheng. Clinical study on repair of open joint wounds and/or wounds with exposed bone fracture using negative pressure wound therapy combined with artificial dermis grafting and autologous skin grafting[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2015, 31(2): 93-97. doi: 10.3760/cma.j.issn.1009-2587.2015.02.004
    [14]ZUO Hai-bin, PENG Dai-zhi, ZHENG Bi-xiang, CHEN Bo, LIU Xiao-ling, WANG Yong, ZHOU Ling. Effect of particulate allogeneic acellular dermal matrix (PADM) combined with autologous splitthickness skin (STS) on wound healing in rats[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2011, 27(1): 10-15. doi: 10.3760/cma.j.issn.1009-2587.2011.01.005
    [15]HUANG Bo-gao, LIAO Zhen-jiang, ZHANG Qin, DOU Yi. Comparison between intermingled skin transplantation and microskin grafting in repairing massive deep burn[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2009, 25(6): 448-450. doi: 10.3760/cma.j.issn.1009-2587.2009.06.017
    [16]WU Jun, WANG Xi-bua, HUANG Zheng-gen. The study in immunology after skin transplantation[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2008, 24(5): 349-351.
    [17]SUN Xing-hui, WU Jun, YI Shao-xuan, YANG Shun-liang, WU Wi-zhen, TAN Jian-ming. Prolongation of survival time of allogenous skin graft after transfection of Molluscum contagiosum virus 148 gene in rats[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2006, 22(1): 46-49.
    [18]XIE Wei-Guo, Werner Lindenmaier, Stefan Gryzybowski, Hans-Gunther Machens. Influence of vascular endothelial growth factor gene modification on skin substitute grafted on nude mice[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2005, 21(3): 203-206.
    [19]YANG Yan-ni, PENG Dai-zhi, WU su-hua, ZHOU Xin, LIU Jing, DONG Zheng-xue. Influence of mixed grafting of autologous and allogeneic microskin on burn wound healing in rats[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2004, 20(4): 229-231.
  • Cited by

    Periodical cited type(24)

    1. 刘晓慧,张鲜英,曹广通,刘毅. 复合皮移植联合VSD修复碾压伤致肘关节外露. 中国美容医学. 2024(01): 4-6 .
    2. 段雪敬,王倩,郭秀侠,赵宇辉,王阳,张静涛. 人工真皮复合自体刃厚皮片移植修复皮肤软组织缺损. 中国美容医学. 2023(01): 45-48 .
    3. 中国老年医学学会烧创伤分会,中国生物材料学会烧创伤创面修复材料分会,中国医师协会创面修复专业委员会. 热压伤创面临床诊疗全国专家共识(2023版). 中华烧伤与创面修复杂志. 2023(03): 201-208 . 本站查看
    4. 刘江涛,王一勇,欧阳容兰,黄书润. 指背动脉穿支皮瓣修复手指深度创面的临床疗效. 安徽医学. 2023(06): 722-725 .
    5. 韩志新,牛大伟,樊昌伟,李振超. 脱细胞真皮联合刃厚皮修复儿童皮肤软组织缺损创面的临床效果. 中国美容医学. 2023(07): 5-8 .
    6. 刘宏,刘毅,陈黎明,赵若梅. 应用异种脱细胞真皮基质修复钢板外露难愈性创面1例. 甘肃医药. 2023(08): 762-764 .
    7. 李鲜慧,张家盛,邹成友,余卓安,高峻青. 伤科黄水联合人工真皮治疗手指急性全层皮肤缺损创面自动上皮化的疗效观察. 中国中医急症. 2023(09): 1587-1590 .
    8. 孙恒亮,蒋邦红,占利民,汪辉,孙群. 创面修复中脱细胞异体真皮复合移植的应用. 皖南医学院学报. 2023(05): 461-464 .
    9. 邬佳敏,杨豪,李祺,罗桃凡,杨颇,黄维琛. 局部注射富血小板血浆联合双层人工真皮治疗四肢肌腱外露创面的临床疗效. 中华烧伤与创面修复杂志. 2023(09): 849-856 . 本站查看
    10. 龙照忠,崔泽龙,王彤华,宋蕊,首家保. 富血小板血浆联合lando双层人工真皮治疗骨/肌腱外露的临床研究. 中国美容整形外科杂志. 2023(12): 726-729+767 .
    11. 冯颜杰,欧阳欢庆,涂智鑫,袁剑,吴伟强. 双层人工真皮在手部或足部骨质肌腱外露创面治疗中的应用效果分析. 世界复合医学. 2023(10): 54-56+60 .
    12. 曾皓,张烁,徐泽华,罗文跃,龙丽芸. 双层人工真皮在骨质肌腱外露创面中的应用. 临床医药实践. 2022(08): 583-585+618 .
    13. 杨福强,张彬,侯书健,孙乐天,刘宏章,娄云鹏,陈振雨. 双层人工真皮结合自体皮片移植治疗四肢皮肤软组织缺损的临床疗效. 中华手外科杂志. 2022(02): 91-95 .
    14. 桑晨,王栋,丁金艳,李小龙,王政刚,毛宇峰. 人工真皮在重度烧伤患者关节瘢痕挛缩松解术后创面修复中的应用效果分析. 中国烧伤创疡杂志. 2022(06): 430-433+440 .
    15. 姜晓华,徐世健,马合龙,武成静,宋荣会. 人工真皮结合刃厚皮片移植在复杂性手外伤创面闭合中的应用. 中国现代手术学杂志. 2022(06): 458-461 .
    16. 陈欣,杜伟力,温春泉,张琮,田彭. 单层型+双层型人工真皮复合移植修复下肢大面积骨外露创面的疗效. 中华创伤杂志. 2021(06): 519-525 .
    17. 赵远,闵定宏,郭光华,陈子清. 人工真皮在创面修复中的应用进展. 实用临床医学. 2021(03): 91-95 .
    18. 牛大伟,郭鹏飞,韩志新. 不同真皮替代材料联合封闭负压引流技术修复糖尿病患者肌腱外露创面的效果. 河北医科大学学报. 2021(10): 1161-1165 .
    19. 吴礼孟,孙充洲,代强. 人工真皮基质联合刃厚皮片移植修复手足部肌腱及骨外露疗效观察. 中国美容医学. 2021(10): 45-47 .
    20. 黄谋璋,郭九生,朱小荣. 翻卷技术的带蒂筋膜瓣联合游离植皮替代游离皮瓣治疗骨、肌腱外露创面的临床效果. 中国当代医药. 2021(29): 91-93+97 .
    21. 韩志新,牛大伟,樊昌伟,李振超. 自体刃厚皮片+脱细胞异体真皮联合创面封闭负压引流修复皮肤软组织缺损. 中国临床研究. 2021(11): 1491-1494 .
    22. 狄海萍,母心灵,史继静,薛继东,刘磊,郭海娜,邢培朋,夏成德. 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. 中华烧伤杂志. 2021(12): 1130-1136 .
    23. 蒋亮,朱红菊,唐佳玉,贺万强,朱雅竹. 藻酸盐敷料联合rhGM-CSF用水胶体封闭治疗肌腱、骨外露的疗效研究. 中华损伤与修复杂志(电子版). 2020(05): 376-382 .
    24. 靳雪义,张宏,张岿. 人工真皮联合瘢痕断层皮片修复治疗在烧伤后四肢大关节部位瘢痕增生挛缩畸形患者中的应用. 中国医疗美容. 2020(12): 49-53 .

    Other cited types(6)

  • Created with Highcharts 5.0.7Amount of accessChart context menuAbstract Views, HTML Views, PDF Downloads StatisticsAbstract ViewsHTML ViewsPDF Downloads2024-052024-062024-072024-082024-092024-102024-112024-122025-012025-022025-032025-0401020304050
    Created with Highcharts 5.0.7Chart context menuAccess Area Distribution其他: 2.5 %其他: 2.5 %其他: 0.4 %其他: 0.4 %China: 0.7 %China: 0.7 %[]: 1.1 %[]: 1.1 %上海: 3.0 %上海: 3.0 %上饶: 0.2 %上饶: 0.2 %东莞: 0.5 %东莞: 0.5 %中山: 0.5 %中山: 0.5 %丽水: 0.4 %丽水: 0.4 %乌鲁木齐: 0.2 %乌鲁木齐: 0.2 %乐山: 1.1 %乐山: 1.1 %佛山: 0.4 %佛山: 0.4 %六盘水: 0.4 %六盘水: 0.4 %兰州: 0.4 %兰州: 0.4 %北京: 1.1 %北京: 1.1 %北方邦: 0.2 %北方邦: 0.2 %南京: 1.3 %南京: 1.3 %南宁: 0.7 %南宁: 0.7 %南昌: 2.7 %南昌: 2.7 %合肥: 0.2 %合肥: 0.2 %周口: 0.2 %周口: 0.2 %哥伦布: 0.9 %哥伦布: 0.9 %唐山: 0.7 %唐山: 0.7 %大连: 0.7 %大连: 0.7 %天津: 0.2 %天津: 0.2 %太原: 0.7 %太原: 0.7 %宁波: 0.2 %宁波: 0.2 %安康: 0.2 %安康: 0.2 %巴音郭楞: 0.2 %巴音郭楞: 0.2 %常德: 1.3 %常德: 1.3 %广州: 2.0 %广州: 2.0 %张家口: 3.6 %张家口: 3.6 %成都: 1.8 %成都: 1.8 %扬州: 0.7 %扬州: 0.7 %揭阳: 0.4 %揭阳: 0.4 %无锡: 0.4 %无锡: 0.4 %昆明: 0.7 %昆明: 0.7 %杭州: 0.5 %杭州: 0.5 %桂林: 0.4 %桂林: 0.4 %梧州: 0.4 %梧州: 0.4 %武汉: 0.5 %武汉: 0.5 %江门: 0.2 %江门: 0.2 %沈阳: 0.4 %沈阳: 0.4 %泉州: 0.4 %泉州: 0.4 %洛阳: 0.5 %洛阳: 0.5 %济南: 0.5 %济南: 0.5 %深圳: 1.3 %深圳: 1.3 %漯河: 0.5 %漯河: 0.5 %珠海: 0.5 %珠海: 0.5 %盐城: 1.1 %盐城: 1.1 %石家庄: 0.2 %石家庄: 0.2 %福州: 0.5 %福州: 0.5 %芒廷维尤: 41.6 %芒廷维尤: 41.6 %芝加哥: 0.2 %芝加哥: 0.2 %苏州: 0.2 %苏州: 0.2 %西宁: 2.5 %西宁: 2.5 %西安: 0.4 %西安: 0.4 %贵阳: 0.4 %贵阳: 0.4 %运城: 0.2 %运城: 0.2 %邯郸: 0.4 %邯郸: 0.4 %郑州: 0.7 %郑州: 0.7 %鄂州: 0.2 %鄂州: 0.2 %重庆: 8.4 %重庆: 8.4 %铁岭: 1.1 %铁岭: 1.1 %长沙: 1.8 %长沙: 1.8 %青岛: 1.3 %青岛: 1.3 %鹤壁: 0.2 %鹤壁: 0.2 %黄冈: 0.4 %黄冈: 0.4 %其他其他China[]上海上饶东莞中山丽水乌鲁木齐乐山佛山六盘水兰州北京北方邦南京南宁南昌合肥周口哥伦布唐山大连天津太原宁波安康巴音郭楞常德广州张家口成都扬州揭阳无锡昆明杭州桂林梧州武汉江门沈阳泉州洛阳济南深圳漯河珠海盐城石家庄福州芒廷维尤芝加哥苏州西宁西安贵阳运城邯郸郑州鄂州重庆铁岭长沙青岛鹤壁黄冈

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (414) PDF downloads(60) Cited by(30)
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return