The Clinical Application Of Artificial Dermis Combined With Autologous Edge Thick Skin Graft In The Repair Of Soft Tissue Defects Of The Extremities

ObjectiveTo study the clinical effect of artificial dermis combined with autologous edge thickness skin graft for repair of soft tissue defects of the extremities MethodsA total of 34 hospitalized patients from October 2015 to January 2018 were collected from the Department of orthopedics and orthopedics in our hospital,All of them were diagnosed as soft tissue defects of the extremities(including the wound after scar resection).According to the random number method,the patients were divided into the observation group and the control group.The two groups were treated with different treatments.17 patients in the observation group were repaired by artificial dermis combined with autologous edge thick skin graft,Artificial dermis was implanted after first stage debridement of the wound,The wounds were immobilized and the affected limbs were immobilized.After the formation of granulation tissue on the wound surface,we removed the silica gel mold on the surface of artificial dermis,and then implanted the autologous split thickness skin graft in the two stage.In the control group,17 patients received full-thickness skin or skin flap transplantation.According to the wound site and depth of wound,appropriate donor site was selected,after routine skin grafting operation.Observed and recorded one week after the two groups of patients with surgical skin graft survival rate,patients satisfaction,treatment of skin area for surgery were followed up for 3 months after surgery and by scar hyperplasia,according to the Vancouver scar scale were recorded in two groups of patients the wound scar score,and statistical analysis;ResultsAfter treatment,the patients in the observation group were treated with artificial dermis and autologous edge thick skin graft to repair tissue defects,16 patients had satisfactory appearance after the operation,and the skin color and texture were acceptable.There was no scar proliferation and contracture in the skin graft area,and the donor site was basically scarless.In the observation group,1 patients were exposed to dermal dermis and necrotic lysis due to poor blood supply and infection of wound.The control group was treated with traditional full thickness skin or flap,15 cases of wound healing effect is acceptable,2 cases of necrosis,and later skin grafting surgery.The patients in the control group showed obvious scar hyperplasia in the later stage of the wound.The skin pigmentation was obvious,the texture was hard,and the scar of the skin donor area was obvious.After comparing the two groups,the survival rate of the skin in the observation group was excellent: 15 cases,1 cases and 1 cases: the survival rate of the skin and flap in the control group was excellent: 9 cases,6 cases and 2 cases.The scar growth in the skin graft and donor site of the observation group was(2.06±2.93)and(0.94±1.91)points,which were better than those in the control group(3.65±1.62)and(3.65±5.06)points,respectively.The Vancouver score was significantly higher than that in the control group.In the survey of patient satisfaction,the patients in the observation group were very satisfied,16 cases,1 cases satisfied,0 cases not satisfied,the control group: 12 cases were very satisfied,3 cases were satisfied,2 cases were not satisfied,the above differences were statistically significant,P < 0.05.ConclusionArtificial dermis with split thickness autologous skin graft for repair of skin and soft tissue defect wound effect,simple operation,high survival rate of skin graft,postoperative wound without obvious scar contracture,and has no donor site of patients two patients for the treatment of injury,high satisfaction,is an effective way for wound repair,worth clinical application.