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双层人工真皮联合负压封闭引流和自体刃厚皮片移植治疗慢性难愈合创面的疗效
Therapeutic effect of dual-layer artificial dermis combined with vacuum sealing drainage and autologous split-thickness skin graft on chronic refractory wounds
- 局解手术学杂志 2025年34卷第2期 页码：125-129
- 作者机构：
1.承德医学院附属医院手足外科，河北 承德 067000
2.围场县卫生健康局，河北 承德 067000
- 作者简介：
李小东，E-mail：15097824763@163.com
- 基金信息：河北省医学科学研究课题计划项目(20241445)
DOI：10.11659/jjssx.12E023098
中图分类号： R622纸质出版日期：2025-02-25，
收稿日期：2023-12-21，
- 稿件说明：
移动端阅览
隋磊, 谢强, 孔宇, 等. 双层人工真皮联合负压封闭引流和自体刃厚皮片移植治疗慢性难愈合创面的疗效[J]. 局解手术学杂志, 2025,34(2):125-129.
SUI LEI, XIE QIANG, KONG YU, et al. Therapeutic effect of dual-layer artificial dermis combined with vacuum sealing drainage and autologous split-thickness skin graft on chronic refractory wounds. [J]. Journal of regional anatomy and operative surgery, 2025, 34(2): 125-129.
隋磊, 谢强, 孔宇, 等. 双层人工真皮联合负压封闭引流和自体刃厚皮片移植治疗慢性难愈合创面的疗效[J]. 局解手术学杂志, 2025,34(2):125-129. DOI： 10.11659/jjssx.12E023098.
SUI LEI, XIE QIANG, KONG YU, et al. Therapeutic effect of dual-layer artificial dermis combined with vacuum sealing drainage and autologous split-thickness skin graft on chronic refractory wounds. [J]. Journal of regional anatomy and operative surgery, 2025, 34(2): 125-129. DOI： 10.11659/jjssx.12E023098.
摘要
目的
2
探讨双层人工真皮联合负压封闭引流和自体刃厚皮片移植治疗慢性难愈合创面的临床疗效。
方法
2
前瞻性选取60例慢性难愈合创面患者，按照随机数字表法将其分为对照组（30例）与观察组（30例）。对照组患者Ⅰ期采用单纯负压封闭引流治疗，Ⅱ期采用自体刃厚皮片移植；观察组患者Ⅰ期采用双层人工真皮联合负压封闭引流，Ⅱ期采用自体刃厚皮片移植。观察2组患者移植自体刃厚皮片成活情况、不良反应、瘢痕情况[温哥华瘢痕评估量表（VSS）评分]。对比2组患者治疗前后疼痛程度[视觉模拟量表（VAS）评分]、血清基质金属蛋白酶13（MMP-13）水平、血清金属蛋白酶抑制剂1（TIMP-1）水平及MMP-13/TIMP-1值。
结果
2
治疗后，观察组患者移植自体刃厚皮片成活情况优于对照组，不良反应发生率、植皮区与供皮区VSS评分、疼痛程度低/轻于对照组，差异均有统计学意义（
P<
0.05）；治疗后，2组患者血清MMP-13水平、MMP-13/TIMP-1值均低于治疗前，血清TIMP-1水平均高于治疗前，且观察组变化幅度较对照组更大，差异
均有统计学意义（
P
<
0.05）。
结论
2
双层人工真皮联合负压封闭引流和自体刃厚皮片移植治疗慢性难愈合创面效果显著，可增加移植自体刃厚皮片成活率，减少不良反应，减轻瘢痕情况及疼痛程度，调节血清MMP-13、TIMP-1水平。
Abstract
Objective
2
To investigate the clinical efficacy of dual-layer artificial dermis combined with vacuum sealing drainage and autologous split-thickness skin graft in the treatment of chronic refractory wounds.
Methods
2
A total of 60 patients with chronic refractory wounds were prospectively selected and divided into the control group （30 cases） and the observation group （30 cases） according to random number table method. In the control group， patients were treated with simple vacuum sealing drainage in the first phase and autologous split-thickness skin graft in the second phase. In the observation group，patients received dual-layer artificial dermis combined with vacuum sealing drainage in the first phase and autologous split-thickness skin graft in the second phase. The survival of autologous split-thickness skin，the incidence of adverse reactions， and the degree of scarring ［Vancouver scar scale （VSS） score］ of patients in the two groups were observed. The degree of pain before and after treatment ［visual analogue scale （VAS） score］， serum matrix metalloproteinase 13 （MMP-13） level， serum tissue inhibitor of metalloproteinase 1 （TIMP-1） level， and MMP-13/TIMP-1 ratio of patients in the two groups were compared before and after treatment.
Results
2
After treatment， the survival rate of autologous split-thickness skin in the observation group was better than that in the control group， the incidence of adverse reactions， the VSS score of the graft site and the donor site， and the pain degree in the observation group was lower/lighter than those in the control group， and the above differences were statistically significant （
P
<
0.05）.After treatment， the serum MMP-13 level and MMP-13/T
IMP-1 ratio of patients in the two groups were lower than those before treatment， and the serum TIMP-1 level was higher than that before treatment， and the changes in the observation group were greater than that in the control group， and the differences were statistically significant （
P
<
0.05）.
Conclusion
2
Dual-layer artificial dermis combined with vacuum sealing drainage and autologous split-thickness skin graft have significant effects in the treatment of chronic refractory wounds， which can increase the survival rate of autologous split-thickness skin， reduce adverse reactions， alleviate scar conditions and pain degree， and regulate serum MMP-13 and TIMP-1 levels.
关键词
慢性难愈合创面MMP-13TIMP-1人工真皮负压封闭引流自体刃厚皮片移植
Keywords
chronic refractory woundsMMP-13TIMP-1artificial dermisvacuum sealing drainageautologous split-thickness skin graft
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