Suzuki Yushi, Tanaka Ichiro, Sakai Shigeki, Yamauchi Tomohiro
Department of Plastic and Reconstructive Surgery, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan.
Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Shinjuku, Japan.
Arch Plast Surg. 2021 Mar;48(2):208-212. doi: 10.5999/aps.2020.00843. Epub 2021 Mar 15.
There are currently no guidelines for the postoperative wound management of the hard-palate donor site in cases involving mucosal harvesting. This study describes our experiences with the use of an artificial dermis for early epithelialization and transparent plate fixation in cases involving hard-palate mucosal harvesting.
A transparent palatal plate was custom-fabricated using a thermoplastic resin board. After mucosal harvesting, an alginic acid-containing wound dressing (Sorbsan) was applied to the donor site, which was then covered with the plate. After confirming hemostasis, the dressing was changed to artificial dermis a few days later, and the plate was fixed to the artificial dermis. The size of the mucosal defect ranged from 8×25 to 20×40 mm.
Plate fixation was adequate, with no postoperative slippage or infection of the artificial dermis. There was no pain at the harvest site, but a slight sense of incongruity during eating was reported. Although the fabrication and application of the palatal plate required extra steps before and after harvesting, the combination of the artificial dermis and palatal plate was found to be very useful for protecting the mucosal harvest site, and resulted in decreased pain and earlier epithelialization.
The combination of artificial dermis and a transparent palatal plate for wound management at the hard-palate mucosal donor site resolved some of the limitations of conventional methods.
目前在涉及黏膜采集的病例中，对于硬腭供区术后伤口管理尚无指南。本研究描述了我们在硬腭黏膜采集病例中使用人工真皮促进早期上皮化及透明板固定的经验。
使用热塑性树脂板定制透明腭板。黏膜采集后，将含藻酸的伤口敷料（Sorbsan）应用于供区，然后用该板覆盖。确认止血后，几天后将敷料更换为人工真皮，并将板固定于人工真皮上。黏膜缺损大小为8×25至20×40毫米。
板固定良好，术后人工真皮无移位或感染。采集部位无疼痛，但有患者报告进食时有轻微不适感。尽管腭板的制作和应用在采集前后需要额外步骤，但发现人工真皮与腭板的组合对保护黏膜采集部位非常有用，且能减轻疼痛并促进早期上皮化。
人工真皮与透明腭板联合用于硬腭黏膜供区伤口管理解决了传统方法的一些局限性。
