Abstract: Objective　To explore the clinical effect of bilayer artificial dermis combined with autologous skin graft in repairing skin and soft tissue defects of fingers with tendon and bone exposure. Methods　A total of 43 patients of finger skin and soft tissue defects with tendon and bone exposure admitted from September 2020 to October 2021 were retrospectively analyzed. Bilayer artificial dermis combined with autologous skin graft was used as the observation group (n=16) and pedicled flap was used as the control group (n=27). The treatment of the two groups were observed and compared, including the interval between two surgeries, the survival rate of skin graft/flap and the length of hospital stay. Vancouver scar scale (VSS) was used for scar score 3 months after operation. The recovery of finger sensation was scored before surgery, 1 month and 3 months after surgery, and two-point resolution test was performed 3 months after surgery. Results　The interval between two surgeries and  the length of hospital stay in the observation group were both significantly longer thanthose in the control group (P<0.05), while there was no significant difference in the survival rate of skin graft/flap between the two groups (P>0.05). All patients recovered well 3 months after operation without obvious skin ulceration. There were no significant differences in the color, vascular distribution and softness of VSS scores between the two groups (P>0.05), and the thickness of observation group was significantly lower than that of control group (P<0.05). The sensory recovery score of observation group was significantly higher than that of control group at 1 and 3 months after operation (P<0.05). The sensory recovery scores of the two groups 1 month and 3 months after surgery were significantly higher than before surgery, and the sensory recovery scores of the two groups 3 months after surgery were significantly higher than 1 month after surgery (P<0.05). Three months after surgery, there was no significant difference in patients' two-point resolution of the two groups(P>0.05). Conclusion　Bilayer artificial dermis combined with autologous skin graft can effectively repair the finger skin and soft tissue defects with tendon and bone exposure. Compared with pedicled skin flap, domestic bilayer artificial dermis Lando can achieve shorter hospital stay and more beautiful appearance of fingers, providing a new choice for clinical repair of such wounds.

Key words: Bilayer artificial dermis, 　Autologous skin graft, 　Tendon exposure, 　Bone exposure