慢性中耳炎根治術患者の恵皮部への滅菌凍結乾燥豚皮（アロアスク）の使用経験

THE CLINICAL EFFECTS OF LYOPHILIZED PORCINE SKIN (ALLOASK) ON DONER SITE OF RADICAL TREATMENT OF CHRONIC OTITIS MEDIA

　I．はじめに

　慢性中耳炎根治術に際して，通常5×8cmの分層皮膚を必要とすることが多い。筆者らはこの採取に，パージェトフードデルマトームか，ワトソンデルマトームを用いている。これらを使用することにより，好みの厚さ，大きさの分層皮膚が簡単に採取することができる。

　分層皮膚を採取した後にできる広範囲皮膚欠損つまり恵皮部は通常II度熱傷と共通した点が多い。このような皮膚欠損の創傷治癒は上皮再生が主体である。再生上皮細胞の由来は，創縁の表皮細胞および毛包，皮脂腺，汗腺といった皮膚付属器の上皮細胞である。この上皮再生を妨げないような処置が望ましい。この処置には従来から種々の材料が利用されている。たとえば，ソフラチュール，トレックスガーゼ．P．V．A．シート，フィブリン膜．人羊膜，豚皮，軟膏ガーゼ等である^1）。

　In performing the radical treatment of chronic otitis media, usually a graft of 5 × 8cm is used. The authors in daily practice use Padgett-Hood dermatome or Watson dermatome which is able to resect a graft in thickness and size required. Although the treatment of the resected site for grafting has many points common to that of scald at the degree II, the authors used a lyophillized porcine skin irradiated this time (Alloask), and obtained good results. The results are presented here.

　Subject cases were 4 male and 7 female patients totalling 11. The sedative effect of this product was excellent in 4 cases, good in 3 cases and its exudate inhibitory effect was excellent in 4 cases and good in 5 cases. This confirmed the major two effects claimed as the feature of Alloask. The epidermis cuticle formation accelerationg effect of the product showed in almost the same time or a little quicker compared with Sofratulle, which, however, requires further investigation.

　Autolysis of Alloask was observed at high rate but the treatment progressed fairly well after changing the product once. This autolysis is currently in contraversy which also requires further investigation.