The Observation Of The Clinical Effect Of PELNAC In Repaire Of Skin And Soft Tissue Defects

Objective:Through compared with skin flap technique to explore the efficacy of artificial dermis (Pelnac) in repair of complex wounds with soft tissue defects、tendon exposed and bone exposed.Methods:Retrospective analysis of the clinical data—23open limb wounds with soft tissue defects caused by trauma of22patients and21patients selected randomly from the same period patients were cured by transfer skin flap, collected from June2009to June2012. After control infection through debridement and VSD technology, all of these23wounds from Pelnac group were covered by artificial dermis (Pelnac) from12to16days, then given autologous medium thickness skin/blade thickness skin graft after removing the solicon film of Pelnac.Through3-12months follow-up and then compared and analysis of the clinical date of the two groups. Comprehensive assessment the taken and implant skin (flap) areas of the two group whether with color abnormalities (pigmentation too much or missing), scarring, wrinkles, and skin (flap) area whether bloated. Every Abnormality was scored1 point.Based on the composite scores, their treatment appearance effects can be divided into four levels—very good (1abnormality), good (2-3abnormalities), general (with3-4at abnormal), and poor (five or more abnormal items).Statistic and analysis these date with SPSS17.0package.Results:The23wounds of22patients of the Pelnac treatment group, except1patient fails due to infection, the remaining wounds of21patients were well repaired. Its complication rate was4.35%; average hospital stayed was33.24days, the unit defect area hospital stayed was1.87days/cm2; after3-12months follow-up, the appearance of provided/accepted skin (flap) areas:seven cases were "very good",12cases were "good",2cases were "general",no "bad" cases, the average score was2.05±0.34.The21patients of the control flap group, two cases occurred partial necrosis in the distal flap,6cases occurred epidermal necrolysis, the overall complication rate was38.10%; these patients with an average hospital stayed22.90days, the unit defect area hospital stayed was0.90days/cm2;the appearance of provided/accepted skin (flap) areas:5cases were "good",16cases were "general", the average score was4.24±0.39.Compared the two group, the complication of the Pelnac group were lower than the flap group(P<0.05), the hospital stayed time of Pelnac group were longer than the flap group(P<0.05), the appearance of Pelnac group were better than the flap group(P<0.05)Conclusions:1. Pelnac coverage do not need a second skin(flap) donor area compared with flap graft, so less trauma, skin graft was easy to survive, postoperative recovery rapidly, appearance well.The Pelnac group was significantly better than the flap group in postoperative appearance and complications.2. Pelnac need longer treatment cycle, more rigorous sterile requirement, needed second or third stage of skin graft.