目的 探討瘢痕或皮膚腫瘤切除后創面使用皮能快愈敷料（PELNAC，商品名：皮耐克）結合自體刃厚皮覆蓋的治療效果。 方法 回顧分析2010年1月－2013年1月收治的兩組瘢痕或皮膚腫瘤切除術后創面分別使用不同皮片覆蓋的治療效果。A組6例，采用PELANC與自體刃厚皮片復合移植；B組10例，采用自體中厚皮片移植修復。隨訪近期、遠期，對比評估兩組創面存活的皮片外觀，彈性；供皮區愈合情況。 結果 兩組患者皮片完全成活，外觀好，彈性佳，較術前明顯改善。與B組相比，A組供皮區愈合時間短，愈合后色素沉著輕微，無明顯疤痕形成。 結論 采用PELNAC與自身刃厚皮片復合移植修復瘢痕或腫瘤切除后創面，既能夠顯著改善外觀、功能，達到理想的創面修復效果，又不會造成供皮區的繼發性瘢痕增生，是一種理想的創面修復方式。
Objective To investigate the effect of the position of pancreatic duct in pancreatic section on postoperative pancreatic fistula. Methods The clinical data of patients undergoing pancreaticoduodenectomy admitted to the pancreatic surgery department of our hospital from September 2018 to August 2020 were retrospectively collected. The consistency between intraoperative pancreatic section data and preoperative CT cross-sectional images of pancreatic duct was compared, and the occurrence of postoperative pancreatic fistula was analyzed by univariate analysis and multivariate logistic regression model analysis, to determine whether the position of pancreatic duct on pancreatic section during pancreaticojejunostomy had an impact on the occurrence of postoperative pancreatic fistula. Results A total of 373 patients were included in this study. In 44 cases, the ratio of the thickness of the short distance from the center of the pancreatic duct to the edge of the pancreas at the pancreatic section was 0.41±0.09, and the imaging measurement value was 0.40±0.10. The interclass correlation coefficient detection value of the two measurement methods was 0.916 (>0.75), P<0.001, this had high consistency. Patients had a high BMI [OR=1.276, 95%CI (1.154, 1.411), P<0.000 1] and soft pancreatic texture [OR=2.771, 95%CI (1.558, 4.927), P=0.001] were independent risk factors for postoperative pancreatic fistula, while the risk of postoperative pancreatic fistula decreased with the increased proportion of pancreatic duct thickness from center to edge [OR=0.875, 95%CI (0.840, 0.911), P<0.000 1]. Conclusions Patients with high BMI and soft pancreas are independent risk factors for postoperative pancreatic fistula, and the risk of postoperative pancreatic fistula is reduced when the center of pancreatic duct is far from the edge of pancreas. The ratio of short distance from the center of pancreatic duct to the edge of pancreas to the total thickness of pancreas measured by preoperative imaging can be used to evaluate the risk of postoperative pancreatic fistula.