Effect of composite transplantation of artificial dermis and autologous skin graft combined with vacuum sealing drainage in the reconstruction of joint scars
10.3760/cma.j.cn114453-20220626-00193
- VernacularTitle:人工真皮与自体皮片复合移植联合负压封闭引流整复关节部位瘢痕的效果
- Author:
Yongxin CHEN
1
;
Yuanwen ZHANG
;
Zhihui YAO
;
Yao ZHAO
;
Wenming TANG
;
Wendong PAN
Author Information
1. 解放军联勤保障部队第926医院烧伤整形科，开远 661600
- Keywords:
Cicatrix;
Joints;
Artificial dermis;
Vacuum sealing drainage
- From:
Chinese Journal of Plastic Surgery
2023;39(6):590-595
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of composite transplantation of artificial dermis and autologous razor-thin graft combined with vacuum sealing drainage in the repair of joint scar after burn.Methods:The clinical data of patients with scar contracture deformity or scar ulcer after extensive burn admitted to the Department of Burns and Plastic Surgery of No. 926 Hospital of the Joint Logistics Force of PLA from January 2019 to December 2020 were retrospectively analyzed. Patients received one-stage contracture scar excision and release or scar ulcer debridement, Lando ?artificial dermis transplantation combined with vacuum sealing drainage, removal of the silicone membrane after complete vascularization of the wound, and secondary transplantation of autologous razor-thin graft. The survival and long-term appearance of skin graft, formation of scar and function recovery of joint were observed. Results:A total of 32 patients were included, including 24 males and 8 females, aged from 18 to 45 years, with an average age of 33 years. Scars were found in 4 cases of the metacarpophalangeal joint, 4 cases of the wrist joint, 10 cases of the elbow joint, and 14 cases of the knee joint and popliteal fossa. One patient underwent surgery to repair bilateral knee joint scar ulcers simultaneously, resulting in a total of 33 surgical sites. Among them, there were 23 sites of scar contracture deformities, 5 sites of scar ulcers, and 5 sites of scar contracture deformities with scar ulcers. After 2 weeks of artificial dermis coverage, the negative pressure device was removed, and the artificial dermis stent vascularization was good in 32 patients (33 surgical sites). After autologous skin graft transplantation, the survival rate was 100% (33/33). Postoperative follow-up for 3 to 12 months showed that there was no ulceration in the skin graft area, the skin color was close to normal, and there were no obvious scar contractures or hyperplasia. The joint function was satisfactory.Conclusion:The composite transplantation of artificial dermis and autologous razor-thin graft combined with vacuum sealing drainage is good to repair scar contracture or scar ulcer of joint after burn, the skin color and texture after operation, and the recovery of joint function is satisfactory.
