中国骨科临床与基础研究杂志

目的 观察Lando~?人工真皮治疗手足部慢性复杂创面的临床效果。方法 回顾性分析25例手足部慢性复杂创面患者的临床资料，一期行创面扩创手术和负压封闭引流（VSD），二期行Lando~?人工真皮移植，术后2～3周揭除人工真皮硅胶层，21例行自体皮移植三期手术。结果 人工真皮移植2～3周后均完全血管化，创面植皮存活率为100%；术后3～4个月，所有病例创面均愈合。随访时间11～14个月，平均随访时间（12.6±1.2）个月，末次随访时温哥华瘢痕量表（VSS）评分为（4.05±0.59）分，患者手部抓握功能和足部行走功能未受明显影响。结论 Lando~?人工真皮修复手足部慢性复杂创面成活率高，创面愈合好，功能恢复良好，疗效满意。

Objective To observe the clinical effects of Lando~? domestic artificial dermis in the treatment of chronic and complex wounds of hands and feet. Methods Clinical data of 25 patients with chronic and complex wounds of hands and feet were retrospectively analyzed. Patients were treated by the first-stage operation of debridement of wounds with vacuum sealing drainage(VSD). Lando~?artificial dermis transplantation was performed at the second stage. After 2-3 weeks, the silicone layer of artificial dermis was removed, and 21 patients underwent third-stage operation with autologous skin graft. Results Artificial dermis was vascularized fully at 2 to 3 weeks postoperatively, and the survival rate of skin graft was 100%. At 3 to 4 months after the surgery, all wounds were completely healed. The average follow-up time was(12.6 ± 1.2)months(11-14 months). At the latest follow-up, Vancover scar scale(VSS) was(4.05 ± 0.59) point, and grip ability of hand or foot walking functions were almost completely recovered. Conclusion Lando~? domestic artificial dermis in the treatment of chronic and complex wounds of hands and feet has satisfactory clinical effect with high survival rate of skin graft, good wounds healing and well recovery of functions.