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大腿坏死性筋膜炎感染后使用合成可生物降解的临时基质。

Use of a synthetic biodegradable temporising matrix after necrotising fasciitis infection of the thigh.

机构信息

Plastic and Reconstructive Surgery, University Hospital Galway, Galway, Ireland

Plastic and Reconstructive Surgery, University Hospital Galway, Galway, Ireland.

出版信息

BMJ Case Rep. 2022 Jul 14;15(7):e248656. doi: 10.1136/bcr-2021-248656.

Abstract

Biodegradable temporising matrix (BTM NovoSorb; PolyNovo, Melbourne, Australia) is a novel synthetic polyurethane dermal substitute. Licensed in Europe in 2020, it was developed primarily for reconstruction of infected wounds. We present a case of a healthy man in his 60s with necrotising fasciitis of his left thigh. His medical history was significant for recurrent left thigh liposarcoma that was treated years earlier with surgical excision and adjuvant radiotherapy. The affected area was within the previously irradiated tissue, debrided down to fascia and dressed with a vacuum-assisted closure to help regenerate the wound bed. Reconstruction options were limited by having a circumferential thigh defect that was infected. Following the use of NovoSorb BTM, the area was dressed with Acticoat Flex 7 antimicrobial barrier dressing for 5 weeks. Patient mobilisation was permitted. The material integrated very well and formed a soft, pliable healthy dermal layer that was autografted with split thickness skin grafts. This resulted in durable cover of the thigh with good aesthetic contour and minimal contracture.

摘要

可生物降解临时基质(BTM NovoSorb;PolyNovo,澳大利亚墨尔本)是一种新型的合成聚氨酯皮肤替代物。2020 年在欧洲获得许可,主要用于感染性伤口的重建。我们报告了一位 60 多岁健康男性左大腿坏死性筋膜炎的病例。他的病史显著,早年曾因左大腿脂肪肉瘤复发而接受手术切除和辅助放疗。受累区域位于先前接受过放射治疗的组织内,已清创至筋膜,并使用真空辅助闭合敷料以帮助再生伤口床。由于存在感染的环形大腿缺损,重建选择受到限制。使用 NovoSorb BTM 后,该区域用 Acticoat Flex 7 抗菌屏障敷料包扎 5 周。允许患者活动。该材料整合得非常好,并形成了柔软、有弹性的健康真皮层,用刃厚皮片进行自体移植。这使得大腿得到了持久的覆盖,具有良好的美学轮廓和最小的挛缩。

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