Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, Dresden, Germany.
Int Wound J. 2011 Jun;8(3):291-6. doi: 10.1111/j.1742-481X.2011.00785.x. Epub 2011 Mar 30.
As deep soft tissue defects with exposed bone, cartilage or tendons are not suitable for wound closure with skin mesh grafts, other techniques are needed. We report on six patients, one female and five males, aged between 32 and 89 years, and deep soft tissue defects with exposed tendons, cartilage or bone. The aetiology of these defects was vascular (n = 3), tumour surgery (2), and post-traumatic (1). Wounds were treated with a collagen-elastin matrix applied above the exposed structures. In five patients, the procedure was combined with mesh graft transplantation in the same setting. Follow-up varied between 12 and 40 weeks. Wound healing was uncomplicated in all transplanted patients until first dressing change after 7 days. All but one transplant showed a 100% take rate and the transplant was stable within 10-14 days. A complete wound closure was also achieved without transplantation, but this took 8 weeks. No adverse effects were noted. There was no skin contracture of the skin grafts. Collagen-elastin matrix with split-thickness skin grafts is a useful tool in deep soft tissue. The time to heal can be reduced.
对于存在深部软组织缺损并伴有骨、软骨或肌腱外露，不适合采用皮片移植进行闭合的创面，需要采用其他技术。我们报告了 6 例患者，其中 1 例为女性，5 例为男性，年龄 32-89 岁，存在深部软组织缺损并伴有肌腱、软骨或骨外露。这些缺损的病因是血管性（n=3）、肿瘤手术（2）和创伤后（1）。创面应用胶原-弹力蛋白基质覆盖于外露结构上。在 5 例患者中，该操作与网片移植同期进行。随访时间为 12-40 周。所有接受移植的患者在第 7 天首次换药前均无复杂的愈合过程。除 1 例外，所有移植均达到 100%的成活率，且在 10-14 天内稳定。未进行移植也可实现完全的创面闭合，但需要 8 周时间。未观察到任何不良反应。皮片移植无皮肤挛缩。胶原-弹力蛋白基质联合刃厚皮片是深部软组织的一种有用工具，可以缩短愈合时间。
