Kolenik S A, McGovern T W, Leffell D J
Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut 06520-8059, USA.
Dermatol Surg. 1999 Apr;25(4):303-7. doi: 10.1046/j.1524-4725.1999.08230.x.
Immediate reconstruction is the preferred approach to the management of defects following Mohs micrographic surgery. In a minority of patients, however, reconstruction is contraindicated, and a long-term biological dressing that stimulates wound healing and minimizes wound care is desirable.
We wanted to assess the utility of a lyophilized, type I bovine collagen matrix (SkinTemp) in wound care and wound healing following Mohs micrographic surgery.
Fifteen patients were treated with a bovine collagen matrix following Mohs micrographic surgery. Study wounds were evaluated for time to complete granulation, time to complete epithelialization, and adverse reactions including infection and allergy. The time to complete healing (granulation and epithelialization) for this group was compared to 15 size- and site-matched surgical defects.
The use of bovine collagen matrix provided more rapid wound healing than traditional second intention healing at all anatomic sites studied. The time to complete healing averaged 6.1 weeks with bovine collagen matrix versus 9.4 weeks for the control group. Use of bovine collagen matrix required an average of 3.0 dressing changes weekly compared to 7.0 changes weekly in the control group. There were no wound infections or allergic reactions to it.
A Type I bovine collagen matrix provided a safe, readily available alternative to traditional methods of second intention healing. It minimized wound care while reducing the time for complete healing. A larger study should be performed to confirm the results of this pilot study.
即时重建是Mohs显微外科手术后缺损处理的首选方法。然而，在少数患者中，重建是禁忌的，因此需要一种能刺激伤口愈合并减少伤口护理的长期生物敷料。
我们旨在评估冻干的I型牛胶原基质（SkinTemp）在Mohs显微外科手术后伤口护理和伤口愈合中的效用。
15例患者在Mohs显微外科手术后接受了牛胶原基质治疗。对研究伤口的完全肉芽形成时间、完全上皮化时间以及包括感染和过敏在内的不良反应进行评估。将该组的完全愈合时间（肉芽形成和上皮化）与15个大小和部位匹配的手术缺损进行比较。
在所有研究的解剖部位，使用牛胶原基质比传统的二期愈合能实现更快的伤口愈合。使用牛胶原基质时，完全愈合的平均时间为6.1周，而对照组为9.4周。使用牛胶原基质平均每周需要更换3.0次敷料，而对照组为每周7.0次。未出现伤口感染或对其过敏反应。
I型牛胶原基质为传统二期愈合方法提供了一种安全、易于获得的替代方案。它减少了伤口护理，同时缩短了完全愈合的时间。应进行更大规模的研究以证实该初步研究的结果。
