- 期刊
Problem Wounds of the Lower Limb: Management with Collagen Sponge Terudermis
使用Terudermis治療下肢困難傷口之經驗
摘要
背景： 在重建手術上使用人工真皮或再生模板的方式已被廣為使用，特別是針對困難而複雜處理的傷口。在面對無法承受複雜的重建手術的病人，特別是年紀大或健康狀況較差者時，簡單的應用人工真皮的分階段手術提供另一種重建手術的選擇。 目的及目標： 我們選用Terudermis®作為人工真皮的材料，並用於治療困難傷口。我們回朔性的報告我們的經驗。 材料及方法： 從2005年4月到2007年2月，共有8個病人因為沒有接受傳統重建手術的下肢困難傷口，接受使用人工真皮(Terudermis®, Terumo Corporation, Tokyo, Japan)和進一步的植皮手術。我們分析這些病人的病史，傷口大小，年紀，手術的間隔時間和進一步重建後的結果。 結果： 這些傷口都是缺乏血液供應的組織，其中有3個病人是骨骼外露，另外5個病人是肌腱外露。這些病人在接受人工真皮手術後的38.13天內進行自體皮膚移植手術。主要的併發症是有一個病人全層的人工真皮喪失，而有2個病人有部份損失。 結論： 使用人工真皮的重建手術步驟和術後的照顧是很簡單的，而住院的時間也能同時縮短。我們建議對於無法承受傳統重建手術的病人如高齡或健康狀態不佳的病人，使用人工真皮和植皮手術的分階段重建是另一種選擇。
關鍵字
無資料並列摘要
Background: Artificial skin or regenerative template is widely used in reconstructive surgery, especially in the management of difficult and complicated wounds. A simple-staged surgery using a dermal substitute and skin graft could provide a viable option in cases where the patient has advanced age, a poor medical status, or cannot tolerate a major reconstruction procedure. Aim and Objectives: We used Terudermis® as our artificial regenerative template in the management of problem wounds and present our experience. Materials and Methods: From April 2005 to February, 2007, eight patients with problem wounds of the lower limbs who failed conservative management were treated by with artificial dermis (Terudermis®, Terumo Corporation, Tokyo, Japan) and further skin graft. Clinical history, defect size, age, interval time between Terudermis® application to skin graft, and the final results were assessed in all patients. Results: All of the exposed areas included poorly perfused tissue, as well as 3 cases of bone exposure and 5 cases of tendon exposure. All 8 patients received staged surgery and skin graft after an average of 38.13 days following Terudermis® application. Complications included 1 total skin graft loss and 2 cases of partial loss of Terudermis®. Conclusion: The surgical technique for application of artificial dermis and its respective postoperative care are easier than other reconstructive procedures. Additionally, fewer days of in-hospital admission are required. According to our experience, a staged surgery using Terudermis® could provide an alternative choice, especially in elderly patients or in those with poor medical status.