Application of artificial dermis combined with autologous thin layer skin grafts in repairing the refractory wounds

Objective To observe the effects of artificial dermis combined with autologous thin layer skin grafts( composite skin) in repairing the refractory wounds. Methods Thirty patients with refractory wounds were involved who had deep skin soft tissue defect,some cases complicated with exposure of muscles,tendons,bone. All of refractory wounds were repaired by the technology of combining artificial dermis with autologous thin skin transplantation. The technology included 2 steps: firstly,artificial dermis were transplanted on all refractory wounds after the debridement,then autologous thin layer skin were transplanted on artificial dermis 2 ~ 3 weeks after debridement,at that time the dermal tissue growing well and covering exposed tendon,bone tissue. Then the survival rate of artificial dermis and composite skin,the degree of scar hyperplasia,pigmentation change and joint activity were observed to evaluate the effects of composite skin repairing refractory wounds. Results In 25 of 30 patients artificial dermis were survival after transplantation,the survival rate was 83. 3%( 25 /30),the causes of 5 cases failure included local infection 4 cases and instability separately 1 case. The survival rate of composite skin was 100. 0%( 25 /25). The composite skin showed smooth and flexible,no obvious change of scar hyperplasia and pigment on the area of composite skin and doner skin during of follow-up 2 ~ 6 months after discharge. Conclusion The advantages of composite skin grafting were included high survival rate and well texture,no significant change of scar hyperplasia and pigment on the area of composite skin and doner skin,easily operation.