生长因子与创面修复图鉴(中英对照版)

本书主要分为三个部分。第一部分从生长因子讲起，介绍生长因子促进皮肤血管新生，促进皮肤神经及汗腺毛囊等皮肤附属器件功能修复，进而主动促进创面修复，帮助伤者缩短创面愈合时间，减少疤痕。第二部分的典型个案介绍部分以图文形式，将患者症状、诊治过程、注意事项等进行详细阐述，覆盖急性创面修复、压力性创面修复、感染性创面修复、动脉性创面修复、糖尿病足创面修复、癌性创面修复、烧伤烫伤创面修复、静脉性创面等各类典型急慢性创面。第三部分是公益与创面修复，主要介绍“肤生工程”救助创面患者的公益实践。

陈善亮，温州曙光中西医创面修复医院院长，手足显微外科主任，创面修复科主任，副主任医师，温州医科大学合医药研究院《生长因子与复杂创面修复临床研究基地》主任，温州市龙湾区政协委员会第四.五届政协委员，农工党温州市龙湾区基层委一支部主委，2008度被农工党中央委员会评为汶川地震抗震救灾优秀党员，中国康复医学会《康复学组》委员，浙江省医学会显微外科分会委员会委员，浙江省医学会手外科分会委员会委员，温州市医学会手外科分会委员。带领团队完成以下高难度疑难杂症：四肢皮肤软组织缺损修复，难愈慢性创面修复，手足先天畸形矫正，周围神经损伤诊治，断肢(指)再植，拇手指缺损再造，四肢软组织肿瘤诊治，手足慢性疼痛诊治，手足急性创伤诊治，手足指甲疾病诊治，四肢烧烫伤诊治，手足感染性疾病诊治等。

\\\"第一部分?概述 第 1 章?生长因子与创面修复?……………………………………… 3 第一节 创面分类和修复过程 ………………………………………………4 第二节 参与创面修复的生长因子 …………………………………………8 第三节 生长因子递送载体和策略 ……………………………………… 14 第四节 生长因子调控创面修复的进展和思考 ………………………… 18 第 2 章??生长因子的研发与新理论?…………………………………… 31 第一节 生长因子自主研发之路 ………………………………………… 32 第二节 生长因子调节系统 ……………………………………………… 40 第二部分?典型个案介绍 第 3 章?急性创面修复?……………………………………………… 57 案例一 肩部火车压轧性离断 …………………………………………… 58 案例二 断腕伴组织缺损 ………………………………………………… 60 案例三 腕部抽脱性离断伤 ……………………………………………… 64 案例四 小腿绞勒性离断 ………………………………………………… 66 案例五 手掌切割性离断 ………………………………………………… 72 案例六 拇指示指切割性离断 …………………………………………… 74 案例七 双下肢毁损性离断 ……………………………………………… 78 案例八 踝关节撕脱性离断 ……………………………………………… 82 案例九 手掌压轧性离断 ………………………………………………… 84 案例十 右上臂撕脱性离断 ……………………………………………… 88 案例十一 孕妇上臂多段撕脱性离断 …………………………………… 94 案例十二 上臂部撕脱性离断 …………………………………………… 96 案例十三 腕部切割性离断 ………………………………………………102 案例十四 前臂刀砍伤性离断 ……………………………………………106 案例十五 拇指指端缺损 …………………………………………………108 案例十六 拇指远端指间关节皮肤缺损 …………………………………110 Catalogue Part?1?Overview Chapter?1?Growth?Factors?and?Wound?Repair?…………………… 3 Section 1 Classification and repair process of wounds …………………………5 Section 2 Growth factors involved in wound repair ……………………………9 Section 3 Growth factor delivery vehicles and strategies …………………… 15 Section 4 Progress and reflection on the regulation of growth factors in wound repair …………………………………………… 19 Chapter?2?Development?and?New?Theory?of?Growth?Factors?…… 31 Section 1 The path of independent research and development of growth Factors ………………………………………………… 33 Section 2 Growth factor regulation system ………………………………… 41 Part?2?Introduction?to?Typical?Cases Chapter?3?Acute?Wound?Repair?…………………………………… 57 Case 1 Shoulder train crush fracture ………………………………………… 59 Case 2 Broken wrist with tissue defect ……………………………………… 61 Case 3 Wrist detachment injury ……………………………………………… 65 Case 4 Stranded separation of the lower leg ………………………………… 67 Case 5 Palm cutting detachment …………………………………………… 73 Case 6 Finger cutting detachment of thumb indicator ……………………… 75 Case 7 Destructive separation of two lower limbs ………………………… 79 Case 8 Ankle joint tear separation …………………………………………… 83 Case 9 Palm compression induced fracture ………………………………… 85 Case 10 Right upper arm tear separation …………………………………… 89 Case 11 Multiple segment tearing and detachment of the upper arm in pregnant women ………………………………………………… 95 Case 12 Tearing and detachment of upper arm ……………………………… 97 Case 13 Severely severed wrist ………………………………………………103 Case 14 Forearm knife induced amputation …………………………………107 Case 15 Thumb tip defect ……………………………………………………109 Case 16 Skin defect of distal interphalangeal joint of thumb ………………111 案例十七 示指中指环指热压伤皮肤缺损 ………………………………114 案例十八 拇指背侧皮肤缺损 ……………………………………………118 案例十九 中指环指热压伤皮肤坏死 ……………………………………120 案例二十 示指中指掌侧皮肤缺损 ………………………………………122 案例二十一 示指指背皮肤缺损 …………………………………………126 案例二十二 示指甲床缺损指骨外露 ……………………………………128 案例二十三 示指指间关节皮肤软组织缺损 ……………………………132 案例二十四 拇指指腹缺损骨外露 ………………………………………134 案例二十五 足内侧擦伤皮肤缺损 ………………………………………138 案例二十六 手背文身 ……………………………………………………142 案例二十七 拇指缺损 ……………………………………………………144 案例二十八 足背皮肤缺损 ………………………………………………150 案例二十九 上臂大面积撕脱伤 …………………………………………152 案例三十 足背逆行撕脱伤 ………………………………………………158 案例三十一 前臂大面积皮肤缺损 ………………………………………160 案例三十二 下肢大面积撕脱伤伴皮肤缺损 ……………………………162 案例三十三 左前踝皮肤缺损 ……………………………………………168 案例三十四 左足背大面积皮肤软组织缺损 ……………………………170 案例三十五 右足足背胫侧皮肤缺损 ……………………………………174 案例三十六 右侧胫骨骨折术后大面积皮肤软组织缺损 钢板骨外露 …………………………………………………178 案例三十七 足背逆行撕脱、肌腱血管缺损、骨关节骨折 ……………184 案例三十八 示指中指环指离断 …………………………………………190 案例三十九 示指脱套伤离断伤 …………………………………………194 案例四十 左前臂及腕部开放性创伤 ……………………………………196 案例四十一 左肘部开放性创伤、肘部血管神经断裂 …………………200 案例四十二 腕部纵行开放性创伤 ………………………………………204 案例四十三 右前臂开放性创伤，肌腱、血管神经断裂 ………………208 案例四十四 臀部皮肤缺损 ………………………………………………212 案例四十五 手掌多发贯通伤 ……………………………………………216 生长因子与创面修复图鉴 Case 17 Skin defect caused by heat pressure injury on the middle finger of the finger ……………………………………………………115 Case 18 Skin defect on the dorsal side of the thumb …………………………119 Case 19 Skin necrosis caused by finger thermal compression injury ………121 Case 20 Skin defect on the palmar side of the middle finger of the index finger …………………………………………………123 Case 21 Skin defect on the back of the index finger …………………………127 Case 22 Nail bed defect with exposed finger bones …………………………129 Case 23 Skin and soft tissue defects in the interphalangeal joint of the index finger …………………………………………………133 Case 24 Thumb pulp defect with bone exposure ……………………………135 Case 25 Scratches and skin defects on the inner side of the foot ……………139 Case 26 Tattoo on the back of the hand ………………………………………143 Case 27 Thumb defect ………………………………………………………145 Case 28 Skin defect on the back of the foot …………………………………151 Case 29 Large area upper arm tear injury ……………………………………153 Case 30 Retrograde avulsion injury on the back of the foot …………………159 Case 31 Large area skin defect on the forearm ………………………………161 Case 32 Large scale tearing injury of lower limbs with skin defects ………163 Case 33 Left anterior ankle skin defect ………………………………………169 Case 34 Large area skin and soft tissue defect on the left dorsum of the foot …………………………………………………171 Case 35 Right full back tibial skin defect ……………………………………175 Case 36 Large area skin and soft tissue defect with exposed steel plate bone after surgery for right tibial fracture ……………………179 Case 37 Retrograde avulsion of the dorsum of the foot, tendon and vascular defects, and bone and joint fractures ………………………185 Case 38 Disconnection of index finger, middle finger and ring finger ………191 Case 39 Finger detachment injury and detachment injury …………………195 Case 40 Open trauma of left forearm and wrist ………………………………197 Case 41 Left elbow open trauma, elbow vascular and nerve rupture ………201 Case 42 Longitudinal open trauma of wrist …………………………………205 Case 43 Open trauma of the right forearm, tendon, vascular and nerve rupture ………………………………………………………209 Case 44 Skin defect on the hip ………………………………………………213 Case 45 Multiple penetrating injuries to the palm ……………………………217 第 4 章?压力性创面修复???………………………………………… 221 案例一 腰骶尾部压疮 ……………………………………………………222 案例二 右髋压疮合并坏死性肌筋膜炎 …………………………………228 案例三 左侧髋关节化脓性感染伴压疮 …………………………………232 案例四 舞蹈症失能伴骶尾部压疮 ………………………………………236 案例五 人工股骨头置换术后骶尾部巨大压疮 …………………………238 案例六 重度颅脑损伤偏瘫性骶尾部压疮 ………………………………244 案例七 骶尾部Ⅳ期巨大压疮 ……………………………………………248 案例八 慢性再生障碍性贫血合并硬膜下血肿的 压力性损伤（多处） ……………………………………………254 案例九 儿童 4 期压力性损伤 ……………………………………………258 第 5 章?感染性创面修复???………………………………………… 263 案例一 双小腿慢性溃疡 …………………………………………………264 案例二 左小腿内侧溃疡 …………………………………………………268 案例三 会阴部多发溃疡 …………………………………………………272 案例四 抽脂术后继发严重腹壁感染坏死 ………………………………276 案例五 左大腿急性坏死性筋膜炎 ………………………………………280 案例六 小腿破溃经久不愈、钢板外露 …………………………………286 案例七 小腿坏死性筋膜炎 ………………………………………………290 案例八 坏死性脓皮病术后感染 …………………………………………298 案例九 造口旁疝术后切口感染 …………………………………………302 案例十 巨型五步蛇咬伤合并蛇伤性创面 ………………………………306 案例十一 蛇咬伤小腿坏死性筋膜炎 ……………………………………312 第 6 章?静脉性溃疡创面修复???…………………………………… 321 案例一 左侧内外踝静脉性溃疡 …………………………………………322 案例二 双下肢巨大静脉性溃疡 …………………………………………326 案例三 双下肢多发溃疡、左髂静脉压迫综合征 ………………………332 案例四 左下肢内踝静脉性溃疡 …………………………………………336 第 7 章?糖尿病性溃疡创面修复?………………………………… 341 案例一 2 型糖尿病合并坏死性筋膜炎 ……………………………………342 案例二 左下肢动脉硬化闭塞、2 型糖尿病伴糖尿病足 …………………348 生长因子与创面修复图鉴 Chapter?4?Repair?of?Pressure?Wounds?………………………… 221 Case 1 Lumbosacral and coccygeal pressure ulcers …………………………223 Case 2 Right hip pressure ulcer combined with necrotizing fasciitis ………229 Case 3 Purulent infection with pressure ulcers in the left hip joint …………233 Case 4 Dysfunction of chorea with sacrococcygeal pressure ulcers …………237 Case 5 Individuals with massive pressure ulcers in the sacrococcygeal region after femoral head replacement surgery ………………………239 Case 6 Hemiplegic sacrococcygeal pressure ulcer caused by severe traumatic brain injury …………………………………………245 Case 7 Stage 4 giant pressure ulcer in the sacral tail …………………………249 Case 8 Pressure injury in chronic aplastic anemia with subdural hematoma (multiple locations) ………………………………………255 Case 9 Stage 4 stress injury in children ………………………………………259 Chapter?5??Repair?of?Infectious?Wounds?………………………… 263 Case 1 Chronic ulcers in the lower legs ………………………………………265 Case 2 Ulcer on the inner side of the left calf ………………………………269 Case 3 Multiple ulcers in the perineum ………………………………………273 Case 4 Severe abdominal wall infection and necrosis secondary to liposuction surgery ……………………………………………………277 Case 5 Acute necrotizing fasciitis of left thigh ………………………………281 Case 6 Prolonged leg rupture and exposed steel plate ………………………287 Case 7 Necrotizing fasciitis of the lower leg …………………………………291 Case 8 Postoperative infection in necrotizing pyoderma ……………………299 Case 9 Postoperative incision infection in paraostomy hernia surgery ………303 Case 10 Giant five step snake bite combined with snake wound ……………307 Case 11 Necrotizing fasciitis of the calf caused by snake bite ………………313 Chapter?6??Repair?of?Venous?Ulcer?Wounds?…………………… 321 Case 1 Left medial and lateral ankle venous ulcer …………………………323 Case 2 Giant venous ulcers in both lower limbs ……………………………327 Case 3 Multiple ulcers in both lower limbs and left iliac vein compression syndrome ………………………………………………333 Case 4 Left lower limb internal ankle venous ulcer …………………………337 Chapter?7??Repair?of?Diabetes?Ulcer?Wounds?…………………… 341 Case 1 Type 2 diabetes with necrotizing fasciitis ……………………………343 Case 2 Arteriosclerotic occlusion of left lower limb, type 2 diabetes with diabetes foot ……………………………………………………349 案例三 2 型糖尿病伴糖尿病足 ……………………………………………352 案例四 2 型糖尿病合并右足跟坏死性筋膜炎 ……………………………356 案例五 糖尿病足伴周围血管病变（Wagner 4 级） ……………………358 案例六 2 型糖尿病伴糖尿病足、足跟慢性骨髓炎 ………………………364 案例七 糖尿病足伴感染 …………………………………………………368 第 8 章?动脉性坏疽创面修复???…………………………………… 375 案例一 双下肢动脉闭塞性脉管炎，双足坏死 …………………………376 案例二 左下肢大动脉闭塞合并长段骨外露 ……………………………378 案例三 急性下肢动脉栓塞序贯多器官功能衰竭合并 下肢坏死性创面 …………………………………………………384 第 9 章?恶性创面修复?…………………………………………… 391 案例一 足跟部恶性黑色素瘤 ……………………………………………392 案例二 头皮巨大鳞癌溃疡 ………………………………………………394 案例三 小腿骨肉瘤 ………………………………………………………398 案例四 左下肢骨巨细胞瘤 ………………………………………………402 案例五 癌性溃疡、腹壁坏死性肌筋膜炎 ………………………………406 案例六 艾滋病性溃疡 ……………………………………………………410 案例七 背部巨大神经纤维瘤切除修复 …………………………………416 案例八 乳腺癌术后切口感染 ……………………………………………420 第 10 章?烧烫伤创面修复?………………………………………… 427 案例一 双足浅二度烫伤 …………………………………………………428 案例二 下肢烧伤瘢痕大面积挛缩（陈旧性） …………………………430 案例三 双手高压电弧灼伤 ………………………………………………434 案例四 双足开水烫伤 ……………………………………………………438 第 11 章?创面修复的镇痛管理?…………………………………… 443 第一节 术后慢性疼痛的基础认识 ………………………………………444 第二节 疼痛的管理 ………………………………………………………450 第三部分?附录 科技惠民?大爱肤生 ——打造中国最有温度的科技医疗慈善品牌……………………… 466 生长因子与创面修复图鉴 Case 3 Type 2 diabetes with diabetes foot ……………………………………353 Case 4 Type 2 diabetes with necrotizing fasciitis of right heel ………………357 Case 5 Diabetes foot with peripheral vascular disease (Wagner grade 4) ……………………………………………………359 Case 6 Type 2 diabetes with chronic osteomyelitis of foot and heel in diabetes ……………………………………………………………365 Case 7 Diabetes foot with infection …………………………………………369 Chapter?8??Repair?of?Arterial?Gangrene?Wounds?……………… 375 Case 1 Arterial occlusive vasculitis of both lower limbs, necrosis of both feet ……………………………………………………………377 Case 2 Left lower limb arterial occlusion with long segment bone exposure ………………………………………………………………379 Case 3 Sequential multiple organ failure with lower limb necrotic wound caused by acute lower limb arterial embolism ………………385 Chapter?9??Repair?of?Malignant?Wounds?………………………… 391 Case 1 Malignant melanoma in the heel area ………………………………393 Case 2 Giant squamous cell carcinoma ulcer on the scalp …………………395 Case 3 Osteosarcoma of the lower leg ………………………………………399 Case 4 Giant cell tumor of left lower limb bone ……………………………403 Case 5 Cancer ulcer and necrotizing fasciitis of the abdominal wall ………407 Case 6 AIDS ulcer ……………………………………………………………411 Case 7 Removal and repair of a giant neurofibroma in the back ……………417 Case 8 Postoperative incision infection of breast cancer ……………………421 Chapter?10??Repair?of?Burn?and?Scald?Wounds?………………… 427 Case 1 Shallow second degree burns on both feet ……………………………429 Case 2 Large area contracture of lower limb burn scars (old) ………………431 Case 3 High voltage arc burns on both hands ………………………………435 Case 4 Foot scald caused by boiling water …………………………………439 Chapter?11??Pain?Management?for?Wound?Repair?……………… 443 Section 1 Basic understanding of postoperative chronic pain ………………445 Section 2 Pain management …………………………………………………451 Part?3?Appendix Technology?benefits?the?people?and?loves?skin?carc-Build?the?most warm?technology?medical?charity?brand?in?china??……………… 467\\\"