临床外科杂志 ›› 2025, Vol. 33 ›› Issue (4): 357-359.doi: 10.3969/j.issn.1005-6483.20241600

• 论著 • 上一篇    下一篇

人工真皮一期修复指端皮肤缺损伴骨外露创面的临床应用

张梦雪,王正,陶圣祥,漆白文,李宗焕   

  1. 430071 武汉大学中南医院创伤与显微骨科
  • 收稿日期:2024-10-08 出版日期:2025-04-20 发布日期:2025-04-20
  • 通讯作者: 李宗焕,Email:lizonghuan@whu.edu.cn
  • 基金资助:
    国家自然科学基金青年科学基金项目(82402896)

Clinical application of primary repair of fingertip skin defects with bone exposure using one stage artificial dermis

ZHANG Mengxue,WANG Zheng,TAO Shengxiang,QI Baiwen,LI Zonghuan   

  1. Department of Orthopedics Trauma and Microsurgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China
  • Received:2024-10-08 Online:2025-04-20 Published:2025-04-20

摘要: 目的 探讨人工真皮在外伤性手指皮肤缺损伴骨外露创面修复中的临床应用效果。方法 2022年1月~2024年1月收治的指端皮肤缺损伴骨外露创面病人10例共10指,缺损面积0.5cm×1.0cm~1.0cm×1.5cm。清创后均给与人工真皮覆盖创面,术后定期换药。术后3~4周拆除人工真皮外膜,观察创面愈合情况、评估指端皮肤外观及感觉恢复。结果 10例手指远端创面均顺利愈合,愈合时间为3~4周。所有病人均接受了超过3个月的随访,创面愈合情况良好。指腹饱满,皮肤光滑平整,未见明显瘢痕,质地柔软。皮肤感知能力恢复良好,指端无疼痛或过敏症状,两点辨别能力达到3~8mm。按照中华医学会手外科学会制订的上肢功能评定标准:10个指端的感觉恢复达到S3+级别,优良率为100%。结论 人工真皮一期修复指端皮肤缺损伴骨外露创面无供区损伤,手术操作安全简单,修复后手指外观及感觉功能恢复良好,疗效可靠。

关键词: 指端损伤, 皮肤缺损, 骨外露创面, 人工真皮

Abstract: Objective To explore the clinical application effects of artificial dermis in the repair of traumatic finger skin defects with bone exposure.Methods From January 2022 to January 2024,10 patients with fingertip skin defects and bone exposure,totaling 10 fingers,were treated.The defect areas ranged from 0.5 cm×1.0 cm to 1.0 cm×1.5 cm.After debridement,the wounds were covered with artificial dermis,and regular dressing changes were performed postoperatively.The artificial dermis was removed 3-4 weeks post-surgery.The wound healing,skin appearance,and sensory recovery of the fingertip were evaluated.Results All 10 fingertip wounds healed successfully,with a healing time of 3 to 4 weeks.Patients were followed up for more than 3 months,and the wound healing was satisfactory.The finger pads appeared full,the skin was smooth and flat with no obvious scarring,and the texture was soft.Skin sensory ability recovered well,with no pain or hypersensitivity,and the two-point discrimination ability reached 3 to 8 mm.According to the upper limb function evaluation standards set by the Hand Surgery Society of the Chinese Medical Association,the sensory recovery of all 10 fingertips achieved an S3+ level,with a good to excellent rate of 100%.Conclusion The primary repair of fingertip skin defects with bone exposure using artificial dermis resulted in no donor site damage.The surgical procedure is safe and simple,and the appearance and sensory function of the fingers have recovered well,demonstrating reliable efficacy.

Key words: fingertip injury, skin defect, bone exposure wound, artificial dermis

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