Zhang Yongfa, Chen Fuyang, Wu Weiqiang, Xu Zhixian, Li Renbin, Ke Tie
Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou 350004, Fujian Province, PR China; Department of Emergency & Trauma Surgery, Fujian Provincial Hospital, National Regional Trauma Medical Center, No.134 East Street, Gulou District, Fuzhou 350001, Fuiian Province, PR China; Fujian Provincial Key Laboratory of Emergency Medicine, Fujian Provincial Institute of Emergency Medicine, Fujian Emergency Medical Center, Fuzhou 350001, Fujian, PR China.
Trauma Center/Emergency Surgery Department, First Affiliated Hospital of Fujian Medical University, Fuzhou City, Fujian Province, 350004, PR China.
Injury. 2024 Oct;55(10):111755. doi: 10.1016/j.injury.2024.111755. Epub 2024 Jul 31.
The clinical effects of artificial dermis in treating skin and soft tissue defects accompanied by bone or tendon exposure were assessed.
A retrospective analysis was conducted on the clinical data of 45 cases of skin and soft tissue defects accompanied by bone or tendon exposure admitted to the trauma surgery department of Fujian Provincial Hospital between February 2018 and August 2020. They were divided into the artificial dermis and control groups. The wound was assessed using the Vancouver Scar Scale (mVSS), and the postoperative visual analogue scale (VAS) scores were recorded at 3, 6, 9, and 12 months after surgery. At the 12-month after surgery, skin sensation recovery was evaluated using the criteria of the British Medical Research Council (BMRC).
The cases included 26 males and 19 females, aged 50 to 85 years. All patients were followed up for an average of 13.8 months (range: 12-18 months). Compared with controls, the wound healing time of the observation group was longer (35.8 ± 10.6 vs. 28.5 ± 4.8, P = 0.007), without significant differences for the number of operations and length of hospitalization. The mVSS scores were not different between groups (P = 0.294), but the scores decreased with time (P < 0.001), and the group×time interaction was significant (P < 0.001). Similarly, the VAS scores were not different between groups (P = 0.667), but the scores decreased with time (P < 0.001); the group×time interaction was not significant (P = 0.274). At the 12-month mark following the operation, in the artificial dermis group, the MCRR score was S3+ in 23 patients, while it ranged from S0 to S3 in two patients; in the control group, S3+ was observed in 17 patients, and S0-S3 in three (P = 0.815).
Artificial dermis treatment is considered a safe and effective alternative therapy for patients with skin and soft tissue defects accompanied by bone or tendon exposure who cannot tolerate or are unwilling to undergo autologous skin flap transplantation. It offers the advantages of minimal donor site trauma, simplicity in operation, and favorable postoperative functional recovery.
评估人工真皮治疗伴有骨或肌腱外露的皮肤软组织缺损的临床效果。
回顾性分析2018年2月至2020年8月福建省立医院创伤外科收治的45例伴有骨或肌腱外露的皮肤软组织缺损患者的临床资料。将其分为人工真皮组和对照组。采用温哥华瘢痕量表（mVSS）评估伤口，并记录术后3、6、9和12个月的视觉模拟量表（VAS）评分。术后12个月，采用英国医学研究委员会（BMRC）标准评估皮肤感觉恢复情况。
病例包括26例男性和19例女性，年龄50至85岁。所有患者平均随访13.8个月（范围：12 - 18个月）。与对照组相比，观察组伤口愈合时间更长（35.8 ± 10.6 vs. 28.5 ± 4.8，P = 0.007），手术次数和住院时间无显著差异。两组mVSS评分无差异（P = 0.294），但评分随时间下降（P < 0.001），且组×时间交互作用显著（P < 0.001）。同样，两组VAS评分无差异（P = 0.667），但评分随时间下降（P < 0.001）；组×时间交互作用不显著（P = 0.274）。术后12个月时，人工真皮组23例患者MCRR评分为S3 +，2例患者评分为S0至S3；对照组17例患者评分为S3 +，3例患者评分为S0 - S3（P = 0.815）。
对于不能耐受或不愿接受自体皮瓣移植的伴有骨或肌腱外露的皮肤软组织缺损患者，人工真皮治疗被认为是一种安全有效的替代疗法。它具有供区创伤小、操作简单、术后功能恢复良好等优点。
