BackgroundThe reconstruction of large skin and soft tissue defects on the lower extremities is challenging. The skin graft is a simple and frequently used method for covering a skin defect. However, poor skin quality and architecture are well-known problems that lead to scar contracture. The collagen-elastin matrix, Matriderm, has been used to improve the quality of skin grafts; however, no statistical and objective review of the results has been reported.MethodsThirty-four patients (23 male and 11 female) who previously received a skin graft and simultaneous application of Matriderm between January 2010 and June 2012 were included in this study. The quality of the skin graft was evaluated using Cutometer, occasionally accompanied by pathologic findings.ResultsAll 34 patients showed good skin quality compared to a traditional skin graft and were satisfied with their results. The statistical data for the measurement of the mechanical properties of the skin were similar to those for normal skin. In addition, there was no change in the engraftment rate.ConclusionsThe biggest problem of a traditional skin graft is scar contracture. However, the dermal matrix presents an improvement in skin quality with elastin and collagen. Therefore, a skin graft along with a simultaneous application of Matriderm is safe and effective and leads to a significantly better outcome from the perspective of skin elasticity.
However, 48 hours after the operation, she dyspnea along with subcutaneous emphysema on her shoulder (Fig. 1). Diagnostic bronchoscopy revealed an approximately 1.5-cm-sized vertical tracheal laceration above the carina with split thickness (Fig. 2). She was started on antibiotics, O2 inhalation, expectorants and non-per oral. The emphysema spontaneously resolved. The patient was discharged uneventfully on postoperative day 7.Many operations in plastic surgery are simple and quick. However, general endotracheal intubation may be required for various reasons. Therefore, it is important for a plastic surgeon operating on the face to be familiar with the complications of intubation.The incidence of postintubation tracheal laceration is reported to be approximately 1/20,000 [1]. Thus far, the cause of this laceration has not been definitely established, but the condition is generally attributed to pre-existing tracheal wall weakness, difficult intubation, emergency intubation, inexperience of the health professional, a double-lumen tube, and movement of the head and neck while the patient is intubated [2,3]. A higher incidence is observed in patients who have a chronic use of steroids, are of advanced age, are female [4] and/or have other inflammatory lesions of the trachea.The common symptoms of postintubation tracheal laceration are chest discomfort, dyspnea, dysphonia, cough, hemoptysis, mediastinal emphysema, subcutaneous emphysema, and pneumothorax. The tracheal laceration is detected early when the laceration
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