可生物降解临时基质与胶原-软骨素硅双层真皮再生替代物在软组织伤口愈合中的性能：一项回顾性分析。

Performance of biodegradable temporizing matrix vs collagen-chondroitin silicone bilayer dermal regeneration substitutes in soft tissue wound healing: a retrospective analysis.

作者信息

Wu Shannon S, Wells Michael, Ascha Mona, Gatherwright James, Chepla Kyle

机构信息

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.

Case Western Reserve University School of Medicine, Cleveland, Ohio.

出版信息

Wounds. 2022 Apr;34(4):106-115. doi: 10.25270/wnds/2022.106115.

DOI:10.25270/wnds/2022.106115

PMID:35452408

Abstract

INTRODUCTION

This study compared outcomes of soft tissue reconstruction using biodegradable temporizing matrix (BTM) and collagen-chondroitin silicone (CCS) skin substitutes.

OBJECTIVE

In this study, the authors compared wound healing rates and complication rates between BTM and CCS.

MATERIALS AND METHODS

This retrospective study reviewed outcomes for adult patients who underwent soft tissue reconstruction with either BTM or CCS skin substitutes between 2015 and 2020. Demographics, wound characteristics, surgical details, and complications were recorded.

RESULTS

Ninety-seven patients were included, of whom 51 (52.6%) were treated with BTM graft and 46 (47.4%) with CCS bilayer graft. The mean patient age was 48.2 years (range, 18-93 years). Wound etiologies included burn, trauma, iatrogenic, compartment syndrome, skin cancer, and osteomyelitis. The median template size was 147 cm2 and 100 cm2 for BTM and CCS, respectively (P =.337). Skin grafts were applied to 39 patients (84.8%) treated with CCS compared with 28 (54.9%) treated with BTM (P =.006); the remaining wounds healing secondarily. The template-related and skin graft-related complications of infection, dehiscence, and hematoma or seroma were comparable between groups. The rate of skin graft failure was significantly higher in the CCS cohort (n = 9 [23.1%]) compared with the BTM group (n = 1 [3.6%]) (P =.006). More secondary procedures were required after CCS placement (mean ± standard deviation, 1.9 ± 1.8; range, 0-9) than after BTM (mean, 1.0 ± 0.9; range 0-4) (P =.002). There was no statistical significance in the frequency of definitive closure between BTM and CCS (n = 31 [60.8%] vs n = 28 [60.9%], respectively; P =.655).

CONCLUSIONS

Compared with CCS, BTM had comparable closure and complication rates and required fewer secondary procedures and/or subsequent skin grafting.

摘要

引言

本研究比较了使用可生物降解临时基质（BTM）和胶原 - 软骨素硅酮（CCS）皮肤替代物进行软组织重建的结果。

目的

在本研究中，作者比较了BTM和CCS之间的伤口愈合率和并发症发生率。

材料与方法

这项回顾性研究回顾了2015年至2020年间接受BTM或CCS皮肤替代物进行软组织重建的成年患者的结果。记录了人口统计学、伤口特征、手术细节和并发症。

结果

纳入97例患者，其中51例（52.6%）接受BTM移植治疗，46例（47.4%）接受CCS双层移植治疗。患者平均年龄为48.2岁（范围18 - 93岁）。伤口病因包括烧伤、创伤、医源性、骨筋膜室综合征、皮肤癌和骨髓炎。BTM和CCS的中位模板面积分别为147平方厘米和100平方厘米（P = 0.337）。接受CCS治疗的39例患者（84.8%）进行了皮肤移植，而接受BTM治疗的患者为28例（54.9%）（P = 0.006）；其余伤口二期愈合。两组之间与模板相关和与皮肤移植相关的感染、裂开以及血肿或血清肿并发症相当。CCS队列中皮肤移植失败率（n = 9 [23.1%]）显著高于BTM组（n = 1 [3.6%]）（P = 0.006）。放置CCS后比BTM后需要更多的二次手术（平均±标准差，1.9±1.8；范围0 - 9）（BTM平均为1.0±0.9；范围0 - 4）（P = 0.002）。BTM和CCS之间最终闭合频率无统计学意义（分别为n = 31 [60.8%]和n = 28 [60.9%]；P = 0.655）。