阅读说明：本技术 皮肤移植工具及其制作复合皮片的方法 (Skin grafting tool and method for manufacturing composite skin sheet ) 是由 肖仕初 刘攀 帅超群 夏熙明 郑勇军 姜耀男 房贺 吴琼 于 2019-12-20 设计创作，主要内容包括：本发明涉及一种皮肤移植工具及其制作复合皮片的方法,它包括绉纱片,所述绉纱片包括层叠在一起的下层的金属膜层和上层的纱布层,所述绉纱片设置在扩张器上方；所述绉纱片设置有多条横向褶皱和多条纵向褶皱；所述纵向褶皱为整体绉纱片的褶皱,所述横向褶皱是将绉纱片连同纵向褶皱一同折叠的褶皱。本发明首先通过皮肤移植工具依次制作自体皮皮片和异体皮皮片,再将自体皮皮片和异体皮皮片重叠形成复合皮片；本发明皮肤移植工具的可以按不同比例的展开率进行皮肤扩展移植；植皮区形状规则使得皮肤生产快速、均匀；解决大面积烧伤时自体皮源紧张的问题。(The invention relates to a skin transplanting tool and a method for manufacturing a composite skin sheet by the skin transplanting tool, which comprises a crepe sheet, wherein the crepe sheet comprises a lower metal film layer and an upper gauze layer which are laminated together, and the crepe sheet is arranged above an expander; the crepe yarn sheet is provided with a plurality of transverse wrinkles and a plurality of longitudinal wrinkles; the longitudinal direction wrinkles are wrinkles of an integral crepe sheet, and the transverse direction wrinkles are wrinkles formed by folding the crepe sheet together with the longitudinal direction wrinkles. Firstly, sequentially manufacturing an autologous skin sheet and a heterologous skin sheet by a skin transplantation tool, and overlapping the autologous skin sheet and the heterologous skin sheet to form a composite skin sheet; the skin transplantation tool can carry out skin expansion transplantation according to the expansion rates of different proportions; the shape of the skin grafting area is regular, so that the skin production is rapid and uniform; solves the problem of the shortage of autologous skin sources during large-area burn.)

1. A skin grafting tool, it includes crepe yarn piece (1), crepe yarn piece (1) includes metal membranous layer (1.1) and gauze layer (1.2) of upper strata of lower floor that laminate together, its characterized in that: the crepe sheet (1) is arranged above the expander (2); the crepe sheet (1) is provided with a plurality of transverse folds (1.4) and a plurality of longitudinal folds (1.5); the longitudinal folds (1.5) are folds of the integral crepe sheet (1), and the transverse folds are folds of the crepe sheet (2) together with the longitudinal folds (1.5).

2. The skin grafting tool of claim 1, wherein: adhesive glue is sprayed on the whole surface of the gauze layer (1.2) or the contact surface of the gauze layer and the metal film layer (1.1), so that an adhesive layer (1.3) is formed between the gauze layer (1.2) and the metal film layer (1.1); multiple rows of through holes (1.6) are arranged on the crepe yarn sheet (1) at intervals transversely and longitudinally.

3. The skin grafting tool of claim 2, wherein: the bonding layer (1.3) is composed of bonding adhesive tapes (1.31) which are arranged at intervals and transversely in parallel; the through holes (1.6) are square through holes, and the adhesive tape (1.31) is arranged between two rows of square through holes (1.6); the folding lines (1.7) of the transverse pleats (1.4) and the longitudinal pleats (1.5) are respectively overlapped with the central lines of each row of square through holes (1.6) and each column of square through holes (1.6).

4. The skin grafting tool of claim 1, wherein: the expander (2) is formed into a square frame by two L-shaped supports (2.1) which are mutually crossed, and positioning columns (2.2) are arranged on four corners of the expander (2).

5. The skin grafting tool of claim 4, wherein: positioning holes (1.7) are formed in four corners of the crepe sheet (1), and the positioning holes (1.7) are sleeved on the positioning columns (2.2) so that the crepe sheet (1) can be arranged on the expander (2).

6. The skin grafting tool of claim 1, wherein: the frame of the expander (2) is provided with a handheld part (2.3).

7. The skin grafting tool of claim 1, wherein: the metal film layer (1.1) is made of an aluminum foil layer, and the gauze layer (1.2) is made of polyamide double-pleat yarns; in the crepe sheet (1), the unfolded length of each transverse fold (1.4) is the same, and the unfolded length of each longitudinal fold (1.5) is the same.

8. A method for manufacturing a composite leather sheet is characterized by comprising the following steps: the method comprises the following steps:

1) preparing the autologous skin sheet:

a. the method comprises the following steps of (1) taking an autologous skin sheet with the size equal to that of a cork disc by a skin taking machine, enabling a corium layer of the autologous skin sheet to face downwards and be attached to the cork disc, cutting the autologous skin sheet longitudinally and transversely by a skin cutting machine, cutting the autologous skin sheet into N pieces of miniature autologous skin sheets by cutting a seam, spraying glue on the surface of the autologous skin sheet attached to the cork disc, and then attaching the surface of the autologous skin sheet to a gauze layer;

b. removing the cork disc;

c. positioning the crepe sheet laid with the leather sheet on the expander,

the crepe sheet comprises a lower metal film layer and an upper gauze layer which are laminated together, and is arranged above the expander; the crepe yarn sheet is provided with a plurality of transverse wrinkles and a plurality of longitudinal wrinkles; the longitudinal wrinkles are wrinkles of an integral crepe sheet, and the transverse wrinkles are wrinkles formed by folding the crepe sheet together with the longitudinal wrinkles; adhesive glue is sprayed on the whole surface of the gauze layer or the contact surface of the gauze layer and the metal film layer, so that an adhesive layer is formed between the gauze layer and the metal film layer; the bonding layer is composed of bonding adhesive tapes which are arranged in parallel at intervals in the transverse direction; a plurality of rows of through holes are arranged on the crepe sheet at intervals in the transverse and longitudinal directions; the adhesive tape is arranged between the two lines of square through holes; the folding lines of the transverse folds and the longitudinal folds are respectively overlapped with the central lines of each row of square through holes and each column of square through holes;

d. holding two hand-held members in the transverse direction by hands at the same time, and stretching in the transverse direction to stretch the crepe sheet in the transverse direction;

e. holding two hand-held members in the longitudinal direction by hands at the same time, and stretching in the longitudinal direction to stretch the crepe sheet in the longitudinal direction; removing the metal film layer to finally obtain an expanded autologous micro skin sheet array, namely an autologous skin sheet; and a plurality of rows of self-skin through holes which are arranged at intervals in the transverse and longitudinal directions are formed on the self-skin sheets;

2) preparing a variant leather sheet:

A. the method comprises the following steps of taking a variant leather sheet with the size corresponding to that of a cork disc through a leather taking machine, attaching the variant leather sheet to the cork disc with the same size, cutting the variant leather sheet vertically and horizontally through a leather cutting machine, cutting the leather sheet into N pieces of miniature variant leather sheets through a cutting seam, spraying glue on the surface of the variant leather sheet attached to the cork disc, attaching the surface of the variant leather sheet to a gauze layer, spraying glue on the surface of the leather sheet attached to the cork disc, and turning the variant leather sheet to enable the glue surface to be attached to the gauze layer;

B. removing the cork disc;

C. positioning the crepe sheet laid with the leather sheet on the expander,

the crepe sheet comprises a lower metal film layer and an upper gauze layer which are laminated together, and the crepe sheet is arranged above the expander; the crepe yarn sheet is provided with a plurality of transverse wrinkles and a plurality of longitudinal wrinkles; the longitudinal wrinkles are wrinkles of an integral crepe sheet, and the transverse wrinkles are wrinkles formed by folding the crepe sheet together with the longitudinal wrinkles;

D. holding two hand-held members in the transverse direction by hand at the same time, and stretching in the transverse direction to spread out the crepe sheet 1 in the transverse direction;

E. holding two hand-held members in the longitudinal direction by hands at the same time, and stretching in the longitudinal direction to stretch the crepe sheet in the longitudinal direction; removing the metal film layer to finally obtain an expanded micro variant skin sheet array, namely a variant skin sheet;

3) manufacturing the composite leather sheet:

i. firstly, the xenogenic skin sheet is laid on the dilator through the xenogenic skin positioning hole;

secondly, paving the autologous skin sheet on the dilator through the autologous skin positioning hole, and adhering the rubber surface of the adhesive layer of the autologous skin sheet and the crepe sheet of the allogeneic skin sheet to ensure that the allogeneic skin sheet and the autologous skin sheet coincide;

the autologous skin sheets and the allogeneic skin sheets are combined through the adhesive force of the adhesive layer to form an integral minitype allogeneic skin sheet, and the minitype allogeneic skin sheets respectively fall into autologous skin through holes on the expanded autologous skin sheets; thus the autologous skin piece and the allogeneic skin piece are superposed to form the composite skin piece.

9. The method of making a composite skin according to claim 1, wherein:

the allogeneic skin is selected from allogeneic skin preserved in glycerol, allogeneic skin preserved in a deep low temperature refrigerator, allogeneic skin preserved in liquid nitrogen, acellular allogeneic skin and fresh allogeneic skin;

the xenogenic skin sheet is selected from acellular dermal matrix pigskin sheet, acellular dermal matrix sheep skin sheet, acellular dermal matrix frog skin sheet and fresh pigskin sheet.

Technical Field

The invention relates to the technical field of medical instruments for clinically treating skin defects, in particular to a skin transplanting tool and a method for manufacturing a composite skin sheet by using the same.

Background

Currently, the treatment of deep burns with extra large area remains a major challenge for clinicians, with a treatment success rate of 87.1% for burn areas of 60% -69% TBSA (total surface area) and only 47.8% for burn areas greater than 90% TBSA. Timely wound surface repair is one of the keys for improving the success rate of treatment. If a patient with large-area deep burn cannot seal the wound surface in the early stage, great difficulty is brought to subsequent treatment; particularly after failure of the skin graft surgery, the available donor area for burn patients is further reduced, and the wound surface is locally infected, which makes the survival of the subsequent graft difficult. More seriously, under the condition that a large-area wound surface is exposed for a long time, the burn patient often has complications of hyper metabolism, sepsis, MODS and the like, and even endangers life. Therefore, how to repair a large area of deep wound surface by using a limited donor skin area and ensure the survival rate of transplantation is an urgent problem to be solved in the treatment of critically ill burn patients.

Currently, there is a folding flap expansion film on the market, which folds a film and a cushion layer together in the longitudinal and transverse directions into flat folds, respectively. After the skin pieces are adhered to the expansion film and cut, the skin pieces are separated from each other by stretching the expansion film in the longitudinal and transverse directions, but the drainage of the wound surface is poor during skin grafting, and the residual infection rate in the later period of repair is high.

Disclosure of Invention

The invention aims to overcome the defects of the existing skin grafting tool and provides a skin grafting tool and a method for manufacturing a composite skin sheet by using the same.

In order to achieve the purpose, the invention designs a skin transplanting tool, which comprises a crepe yarn sheet, wherein the crepe yarn sheet comprises a lower metal film layer and an upper gauze layer which are laminated together, and the crepe yarn sheet is arranged above an expander; the crepe yarn sheet is provided with a plurality of transverse wrinkles and a plurality of longitudinal wrinkles; the longitudinal direction wrinkles are wrinkles of an integral crepe sheet, and the transverse direction wrinkles are wrinkles formed by folding the crepe sheet together with the longitudinal direction wrinkles.

Further, adhesive glue is sprayed on the whole surface of the gauze layer or the contact surface of the gauze layer and the metal film layer, so that an adhesive layer is formed between the gauze layer and the metal film layer; and a plurality of rows of through holes are arranged on the crepe sheet at intervals in the transverse and longitudinal directions.

Furthermore, the bonding layer is composed of bonding adhesive tapes which are arranged in parallel at intervals in the transverse direction; the through holes are square through holes, and the adhesive tape is arranged between two rows of square through holes; the folding lines of the transverse folds and the longitudinal folds are respectively overlapped with the central lines of each row of square through holes and each column of square through holes.

Furthermore, the expander is a square frame formed by two L-shaped supports which are crossed with each other, and positioning columns are arranged on four corners of the expander.

Furthermore, positioning holes are formed in four corners of the crepe sheet, and the positioning holes are sleeved on the positioning columns so that the crepe sheet can be arranged on the expander.

Still further, all be provided with handheld part on the frame of expander.

Furthermore, the metal film layer is made of an aluminum foil layer, and the gauze layer is made of polyamide double-pleat yarns; in the crepe sheet, the unfolded length of each transverse fold is the same, and the unfolded length of each longitudinal fold is the same.

The invention also provides a method for manufacturing the composite leather sheet, which comprises the following steps:

1) preparing the autologous skin sheet:

a. taking an autologous skin sheet with the size of a cork disc by a skin taking machine according to the size of a wound surface, sticking the corium layer of the autologous skin sheet to the cork disc downwards, cutting the autologous skin sheet vertically and horizontally by a skin cutting machine, cutting the autologous skin sheet into N pieces of miniature autologous skin sheets by cutting a seam, spraying glue on the surface of the autologous skin sheet stuck to the cork disc, and sticking the surface of the autologous skin sheet to a gauze layer;

b. removing the cork disc;

c. positioning the crepe sheet laid with the leather sheet on the expander,

the crepe sheet comprises a lower metal film layer and an upper gauze layer which are laminated together, and is arranged above the expander; the crepe yarn sheet is provided with a plurality of transverse wrinkles and a plurality of longitudinal wrinkles; the longitudinal wrinkles are wrinkles of an integral crepe sheet, and the transverse wrinkles are wrinkles formed by folding the crepe sheet together with the longitudinal wrinkles; adhesive glue is sprayed on the whole surface of the gauze layer or the contact surface of the gauze layer and the metal film layer, so that an adhesive layer is formed between the gauze layer and the metal film layer; the bonding layer is composed of bonding adhesive tapes which are arranged in parallel at intervals in the transverse direction; a plurality of rows of through holes are arranged on the crepe sheet at intervals in the transverse and longitudinal directions; the adhesive tape is arranged between the two lines of square through holes; the folding lines of the transverse folds and the longitudinal folds are respectively overlapped with the central lines of each row of square through holes and each column of square through holes;

d. holding two hand-held members in the transverse direction by hands at the same time, and stretching in the transverse direction to stretch the crepe sheet in the transverse direction;

e. holding two hand-held members in the longitudinal direction by hands at the same time, and stretching in the longitudinal direction to stretch the crepe sheet in the longitudinal direction; removing the metal film layer to finally obtain an expanded autologous micro skin sheet array, namely an autologous skin sheet; and a plurality of rows of self-skin through holes which are arranged at intervals in the transverse and longitudinal directions are formed on the self-skin sheets;

2) preparing a variant leather sheet:

A. the method comprises the following steps of taking a variant leather sheet with the size corresponding to that of a cork disc through a leather taking machine according to the size of a wound surface, pasting the variant leather sheet on the cork disc with the same size, cutting the variant leather sheet vertically and horizontally through a leather cutting machine, cutting the leather sheet into N pieces of miniature variant leather sheets through cutting seams, spraying glue on the surface of the variant leather sheet pasted on the cork disc, pasting the surface of the variant leather sheet on a gauze layer, spraying glue on the surface of the leather sheet pasted on the cork disc, and turning the variant leather sheet to paste the glue surface on the gauze layer;

B. removing the cork disc;

C. positioning the crepe sheet laid with the leather sheet on the expander,

the crepe sheet comprises a lower metal film layer and an upper gauze layer which are laminated together, and the crepe sheet is arranged above the expander; the crepe yarn sheet is provided with a plurality of transverse wrinkles and a plurality of longitudinal wrinkles; the longitudinal wrinkles are wrinkles of an integral crepe sheet, and the transverse wrinkles are wrinkles formed by folding the crepe sheet together with the longitudinal wrinkles;

D. holding two hand-held members in the transverse direction by hands at the same time, and stretching in the transverse direction to stretch the crepe sheet in the transverse direction;

E. holding two hand-held members in the longitudinal direction by hands at the same time, and stretching in the longitudinal direction to stretch the crepe sheet in the longitudinal direction; removing the metal film layer to finally obtain an expanded micro variant skin sheet array, namely a variant skin sheet;

3) manufacturing the composite leather sheet:

i. firstly, the xenogenic skin sheet is laid on the dilator through the xenogenic skin positioning hole;

secondly, paving the autologous skin sheet on the dilator through the autologous skin positioning hole, and adhering the rubber surface of the adhesive layer of the autologous skin sheet and the crepe sheet of the allogeneic skin sheet to ensure that the allogeneic skin sheet and the autologous skin sheet coincide;

the autologous skin sheets and the allogeneic skin sheets are combined through the adhesive force of the adhesive layer to form an integral minitype allogeneic skin sheet, and the minitype allogeneic skin sheets respectively fall into autologous skin through holes on the expanded autologous skin sheets; thus the autologous skin piece and the allogeneic skin piece are superposed to form the composite skin piece.

Preferably, the area of the micro autologous skin sheet is C1 × C2 square millimeters; the area of the micro variant skin sheet is C1 × C2 square millimeters.

Preferably, the allogeneic skin sheets comprise allogeneic skin sheets and xenogeneic skin sheets;

the allogeneic skin is selected from allogeneic skin preserved in glycerol, allogeneic skin preserved in a deep low temperature refrigerator, allogeneic skin preserved in liquid nitrogen, acellular allogeneic skin and fresh allogeneic skin;

the xenogenic skin sheet is selected from acellular dermal matrix pigskin sheet, acellular dermal matrix sheep skin sheet, acellular dermal matrix frog skin sheet and fresh pigskin sheet.

Preferably, the allogeneic skin sheet is a glycerin-preserved allogeneic skin sheet, and the xenogeneic skin sheet is a full-thickness acellular dermal matrix pigskin sheet.

The invention has the beneficial effects that:

the skin transplantation tool can carry out skin expansion transplantation according to the expansion rates of different proportions; the shape of the skin grafting area is regular, so that the skin production is rapid and uniform; solves the problem of the shortage of autologous skin sources during large-area burn.

Drawings

FIG. 1 is a schematic view of a skin grafting tool;

FIG. 2 is a schematic view of the construction of the dilator;

figure 3 is a perspective view of a crepe sheet;

FIG. 4 is an enlarged view of point A of FIG. 3;

FIG. 5 is an enlarged view of point B of FIG. 3;

figure 6 is a schematic diagram of a crepe sheet;

FIG. 6A is a diagram of the initial state of a crepe sheet; FIG. 6B is a drawing of a crepe sheet punch; figure 6C is a longitudinal fold of a crepe sheet; figure 6D is a schematic view of longitudinal folding of a crepe sheet; figure 6E is a cross-fold view of a crepe sheet; FIG. 6F is a crepe sheet fold forming diagram;

FIG. 7 is a schematic view of the bonded layer of crepe sheet shown in FIG. 6;

figure 8 is a schematic size diagram of a crepe sheet;

figure 9 is a schematic illustration of another crepe sheet making process;

figure 9A is a longitudinal fold of a crepe sheet; figure 9B is a schematic view of longitudinal folding of a crepe sheet; figure 9C is a cross-fold view of a crepe sheet; FIG. 9D is a crepe sheet fold forming diagram;

FIG. 10 is a schematic view in the Y direction of FIGS. 6 and 9;

FIG. 11 is a schematic view in the X direction of FIGS. 6 and 9;

FIG. 12 is a drawing of the manufacturing process of the skin patch;

FIG. 13 is a drawing-up view of the dilator;

FIG. 14 is a top view of an autologous skin sheet;

FIG. 15 is a bottom view of an autologous skin sheet;

FIG. 16 is a schematic view of an allogeneic dermal sheet;

FIG. 17 is a schematic view of the production of a composite skin sheet;

FIG. 18 is a schematic view of a composite skin sheet;

in the figure, crepe yarn sheet 1, metal film layer 1.1, longitudinal wrinkles 1.5, gauze layer 1.2, adhesive layer 1.3, adhesive tape 1.31, transverse wrinkles 1.4, longitudinal wrinkles 1.5, through holes 1.6, positioning holes 1.7, folding lines 1.8, expander 2, L-shaped bracket 2.1, positioning column 2.2, hand-held part 2.3, cork disc 3, autologous leather sheet 4, kerf 4.1, micro autologous leather sheet 4.2, autologous leather sheet 5, autologous leather positioning hole 5.1, autologous leather square hole 5.2, allogeneic leather sheet 6, micro allogeneic leather sheet 6.1, allogeneic leather sheet 7, allogeneic leather positioning hole 7.1 and composite leather sheet 8.

Detailed Description

The present invention is described in further detail below with reference to specific examples so as to be understood by those skilled in the art.