Application Of Artificial Dermis Combined With Autologous Thin Layer Skin Grafts Repairing The Refractory Wounds

Objective To observe the effects of artificial dermis combined withautologous thin layer skin grafts (composite skin) in repairing the refractorywounds.Methods Thirty patients with refractory wounds were involved between April，2011to January，2013，those had deep skin soft tissue defect, some casescomplicated with exposure of muscles, tendons, bone. All of refractory woundswere repaired by the technology of combining artificial dermis with autologousthin skin transplantation. The technology included2steps: firstly, artificialdermis were transplanted on all refractory wounds after the debridement, thenautologous thin layer skin were transplanted on artificial dermis2～3weeksafter debridement, at that time the dermal tissue growing well and coveringexposed tendon, bone tissue. Then the survival rate of artificial dermis andcomposite skin, the degree of scar hyperplasia, pigmentation change and jointactivity were observed, to evaluate the effects of composite skin repairingrefractory wounds. Results In24of30patients artificial dermis were survival aftertransplantation,the survival rate was80.0%(24/30), the causes of6cases failureincluded local infection4cases，dermal hematoma1case and instabilityseparately1case. The survival rate of composite skin was91.7%(22/24). Thecomposite skin showed smooth and flexible, no obvious change of scarhyperplasia and pigment on the area of composite skin and doner skin duringof2～6months after discharge.Conclusions the advantages of composite skin grafting were included survivalrate and well texture, no significant change of scar hyperplasia and pigment onthe area of composite skin and doner skin, easily operation were handled.