Ribeiro L M, Serras R, Guimarães D, Vilela M, Mouzinho M M
Hospital São José (Centro Hospitalar Lisboa Central), Lisbon, Portugal.
Ann Burns Fire Disasters. 2018 Sep 30;31(3):228-232.
Third-degree burns of the lower extremities are among the most difficult burn injuries to treat as they frequently expose bone, tendons or articular surfaces. Coverage with a flap is the ideal treatment, but local tissue is often unavailable, and free flaps require sophisticated equipment and perfect microsurgical technique. We demonstrate a treatment option to obtain a stable cutaneous coverage for this kind of injury, consisting in an association of skin grafts, amniotic membrane and bilaminar dermal matrix templates. This combined treatment proved to be an excellent option to cover a wide area of tibial exposure with low donor site morbidity and good functional and aesthetic results. This shows that artificial dermis is a good alternative for treating bone exposure, especially in patients for whom a classic flap reconstruction is not suitable.
下肢三度烧伤是最难治疗的烧伤之一，因为它们经常暴露骨骼、肌腱或关节表面。皮瓣覆盖是理想的治疗方法，但局部组织往往无法使用，而游离皮瓣需要精密的设备和精湛的显微外科技术。我们展示了一种针对此类损伤获得稳定皮肤覆盖的治疗方案，该方案包括皮肤移植、羊膜和双层真皮基质模板联合使用。这种联合治疗被证明是覆盖大面积胫骨外露的极佳选择，供区发病率低，功能和美学效果良好。这表明人工真皮是治疗骨外露的良好替代方案，特别是对于不适合经典皮瓣重建的患者。
