人工真皮在头皮恶性肿瘤颅骨外露创面修复中的应用
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摘要
目的:探讨人工真皮(皮耐克)在修复头皮恶性肿瘤颅骨外露创面中的临床应用。方法:选择2014年1月至2016年5月于本院行头部恶性肿瘤治疗的患者30例,术中按无瘤原则切除后颅骨外露,于颅骨外板均匀分布、间隔1.0cm钻孔至板障层,至新鲜出血,人工真皮(皮耐克)覆盖创面,待2~4周后人工真皮与创面结合生长良好,于人工真皮(皮耐克)表面行自体刃厚皮植皮。结果:30例患者移植刃厚皮片存活率100%,生长良好;3个月后随访愈合良好,皮肤弹性好,无局部皮肤破溃、肿瘤复发等。结论:人工真皮(皮耐克)在无血供颅骨表面能形成类似人真皮的组织结构,从而为创面修复提供可靠的支撑,是一种快速、简单、有效处理头皮恶性肿瘤颅骨外露的方法。
Objective To investigate the effect of artificial dermis(Pelnac) in the repair of skull exposure by scalp malignant tumor. Methods From January 2014 to May 2016, 30 patients with malignant tumors of head, postoperative pathology confirmed for cancer. intraoperative, according to the principle of tumor-free after resection of skull exposure in patients, in cranial uniform distribution, interval 1.0cm drilling to the diploic layer, to fresh hemorrhage. Artificial dermis(Pelnac) covered the wound, after 2-4 weeks of artificial dermis and wound healing well, and do the skin-grafting with the autologous split-thickness skin. Results All the 30 patients' split-thickness skins survived well. Follow-up 3 months, all the patients healing well, with good skin elasticity, no local skin ulceration, without tumor recurrence and so on. Conclusion The artificial dermis(Pelnac) can form the a structure similar to human dermis above the surface of non-blood supply skull, which can provide reliable support for wound repairing. It's a rapid, simply and effective way to dealing with the skull exposure by scalp malignant tumor.
Objective To investigate the effect of artificial dermis(Pelnac) in the repair of skull exposure by scalp malignant tumor. Methods From January 2014 to May 2016, 30 patients with malignant tumors of head, postoperative pathology confirmed for cancer. intraoperative, according to the principle of tumor-free after resection of skull exposure in patients, in cranial uniform distribution, interval 1.0cm drilling to the diploic layer, to fresh hemorrhage. Artificial dermis(Pelnac) covered the wound, after 2-4 weeks of artificial dermis and wound healing well, and do the skin-grafting with the autologous split-thickness skin. Results All the 30 patients' split-thickness skins survived well. Follow-up 3 months, all the patients healing well, with good skin elasticity, no local skin ulceration, without tumor recurrence and so on. Conclusion The artificial dermis(Pelnac) can form the a structure similar to human dermis above the surface of non-blood supply skull, which can provide reliable support for wound repairing. It's a rapid, simply and effective way to dealing with the skull exposure by scalp malignant tumor.
引文
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[2]宋维铭,王佳琦,郭鑫,等.头面部皮肤恶性肿瘤手术切除及组织缺损修复探讨[J].中国美容医学,2010,19(1):1-4.
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[12]Burke JF,Yannas IV,Quinby WC Jr,et al.Successful use of a physiologically acceptable artificial skin in the treatment of extensive burn injury[J].Ann Surg,1981,194(4):413-428.
[13]杜伟力,周业平,田彭,等.人工真皮修复骨外露创面23例效果评价[J].中国组织工程研究与临床康复,2011,15(3):495-498.
[14]Moiemen NS,Staiano JJ,Ojeh NO,et al.Reconstructive surgery with a dermal regeneration template:clinical and histologic study[J].Plast Reconstr Surg,2001,108(1):93-103.
[15]Faulhaber J,Felcht M,Teerling G,et al.Long-term results after reconstruction of full thickness scalp defects with a dermal regeneration template[J].J Eur Acad Dermatol Venereol,2010,24(5):572-577.
[16]Brunetti B,Tenna S,Segreto F,et al.The use of acellular dermal matrix in reconstruction of complex scalp defects[J].Dermatol Surg,2011,37(4):527-529.
[17]Mitsunagan M,Yamamoto Y.Hair transplantation for reconstruction of scalp defects using artificial dermis[J].Dermatol Surg,2011,37(9):1348-1350.
[18]Spector JA,Glat PM.Hair-bearing scalp reconstruction using a dermal regeneration template and micrograft hair transplantation[J].Ann Plast Surg,2007,59(1):63-66.
[2]宋维铭,王佳琦,郭鑫,等.头面部皮肤恶性肿瘤手术切除及组织缺损修复探讨[J].中国美容医学,2010,19(1):1-4.
[3]Goldberg DP.Assessment and surgical treatment of basal cell skin cancer[J].Clin Plast Surg,1997,24(4):673-686.
[4]Roth JJ,Granick MS.Squamous cell and adnexal carcinomas of the skin[J].Clin Plast Surg,1997,24(4):687-703.
[5]Bailey IS,Goldwasser MS.Surgical management offacial skin cancer[J].Oral Maxillofac Surg Clin North Am,2005,17(2):205-233.
[6]Prstojevich S,Nierzwicki BL.Treatment options for premalignant and malignant cutaneous tumors[J].Oral Maxillofac Surg Clin North Am,2005,17(2):147-160.
[7]王常印,崔正军,Seung-Kyu Han,等.头面部皮肤恶性肿瘤手术切除及创面修复与重建的方法探讨[J].中国美容医学,2011,20(11):1694-1697.
[8]Disa JJ,Pusic AL,Hidalgo DH,et al.Simplifying microvascular head and neck reconstruction:A rational approach to donor site selection[J].Ann Plast Surg,2001,47(4):385-389.
[9]Foong D,Babar A,Mc Grouther D,et al.Key points in technique:split thickness skin grafting to bare skull as a single stage procedure[J].J Reconstr Aesthet Surg,2008,61(10):1260-1263.
[10]Molnar JA,De Franzo AJ.Single-stage approach to skin grafting the exposed skull[J].Plast Reconstr Surg,2000,105(1):174-177.
[11]Yannas IV,Burke JF.Design of an artificial skin.Basic design principles[J].J Biomed Mater Res,1980,14(1):65-81.
[12]Burke JF,Yannas IV,Quinby WC Jr,et al.Successful use of a physiologically acceptable artificial skin in the treatment of extensive burn injury[J].Ann Surg,1981,194(4):413-428.
[13]杜伟力,周业平,田彭,等.人工真皮修复骨外露创面23例效果评价[J].中国组织工程研究与临床康复,2011,15(3):495-498.
[14]Moiemen NS,Staiano JJ,Ojeh NO,et al.Reconstructive surgery with a dermal regeneration template:clinical and histologic study[J].Plast Reconstr Surg,2001,108(1):93-103.
[15]Faulhaber J,Felcht M,Teerling G,et al.Long-term results after reconstruction of full thickness scalp defects with a dermal regeneration template[J].J Eur Acad Dermatol Venereol,2010,24(5):572-577.
[16]Brunetti B,Tenna S,Segreto F,et al.The use of acellular dermal matrix in reconstruction of complex scalp defects[J].Dermatol Surg,2011,37(4):527-529.
[17]Mitsunagan M,Yamamoto Y.Hair transplantation for reconstruction of scalp defects using artificial dermis[J].Dermatol Surg,2011,37(9):1348-1350.
[18]Spector JA,Glat PM.Hair-bearing scalp reconstruction using a dermal regeneration template and micrograft hair transplantation[J].Ann Plast Surg,2007,59(1):63-66.