■大伤口,不管病因,可能很难关闭,往往需要先进的治疗。当诸如肌腱和肌肉的底层结构暴露时,愈合这些伤口的复杂性增加。这些结构很难在组织上造粒,伤口成功闭合,无论是通过次要意图还是通过厚度分裂的皮肤移植物或皮瓣,取决于暴露的骨骼或肌腱的足够覆盖。鉴于这些挑战,应探索新的治疗方案,以在该患者人群中取得成功.一种可再吸收的合成混合尺度纤维基质,具有类似于天然人类细胞外基质的结构,在软组织缺损的治疗中越来越受欢迎。
■通过回顾医学图表进行了回顾性病例系列研究。纳入本综述的患者接受了合成混合尺度纤维基质治疗,有暴露结构的深伤口。用合成的混合尺度纤维基质治疗了22例具有各种病因的深部手术伤口的患者,以对伤口床进行造粒,以准备进行分层厚度的皮肤移植或皮瓣闭合,或直到伤口完全重新上皮化。
■患者平均年龄为59.3岁,平均初始伤口大小为210.3cm²。所有伤口都有裸露的结构,其中包括肌肉,脂肪,筋膜,或腱。利用次要意图愈合闭合伤口(23%),桥接到裂层皮肤移植物(63%),或桥接到皮瓣闭合(14%)。所有伤口在平均41.4天内实现完全闭合,没有报告并发症。
■合成混合尺度纤维基质显示出促进肉芽组织在暴露结构上的功效,应被视为复杂软组织重建的新型治疗选择。
UNASSIGNED: Large wounds, regardless of etiology, can be difficult to close and often require advanced treatment. The complexity of healing these wounds increases when underlying structures such as tendon and muscle are exposed. These structures are difficult to granulate tissue over, and successful wound closure, whether through secondary intention or via a split-thickness skin graft or flap, is dependent on sufficient coverage of the exposed bone or tendon. Given these challenges, new treatment options should be explored to achieve successful outcomes in this patient population. A resorbable synthetic hybrid-scale fiber matrix, with a structure similar to that of native human extracellular matrix, is gaining popularity in the treatment of soft tissue defects.
UNASSIGNED: A retrospective case series was conducted via review of medical charts. Patients included in this review were treated with the synthetic hybrid-scale fiber matrix to manage large, deep wounds with exposed structures. Twenty-two patients with deep surgical wounds of various etiologies were treated with the synthetic hybrid-scale fiber matrix to granulate the wound bed in preparation for a split-thickness skin graft or flap closure or until complete re-epithelialization of the wound.
UNASSIGNED: The average patient age was 59.3 years old, and the average initial wound size was 210.3 cm². All wounds had exposed structures, which included muscle, fat, fascia, or tendon. Wounds were closed utilizing healing by secondary intent (23%), bridging to a split-thickness skin graft (63%), or bridging to a flap closure (14%). All wounds achieved total closure within an average of 41.4 days with no reported complications.
UNASSIGNED: The synthetic hybrid-scale fiber matrix demonstrated efficacy encouraging granulation tissue over exposed structures and should be considered as a novel treatment option for complex soft tissue reconstruction.