Co-Graft of Acellular Dermal Matrix and Split Thickness Skin Graft—A New Reconstructive Surgical Method in the Treatment of Hidradenitis Suppurativa

Abstract

Hidradenitis suppurativa is a chronic disease that significantly reduces patients’ quality of life. Patients are chronically treated with systemic therapies, which are often ineffective. Surgical treatment for severe cases of hidradenitis suppurativa is one option for affected patients. Surgical treatment has its limitations, and wound closure may be particularly problematic. This requires the use of reconstructive techniques. The methods of choice for wound closure are split-thickness skin grafts or local flaps reconstructions. However, each method has its limitations. This is a presentation of a new reconstructive surgical method in hidradenitis suppurativa surgery: the use of a co-graft of Acellular dermal matrix and split thickness skin graft as a novel method in wound closure after wide excisions, based on two cases. The results of this method are very promising: we achieved very fast wound closure with good aesthetic results regarding scar formation. In this paper, we used several examinations: laser speckle analysis, cutometer tests, and health-related quality of life (QoL) questionnaire to check the clinical impact of this method. Our initial results are very encouraging. ADM with STSG as a co-graft could be widely used in reconstructive surgery. This is a preliminary study, which should be continued in further, extended research.

Hidradenitis Suppurativa Burdens on Mental Health: A Literature Review of Associated Psychiatric Disorders and Their Pathogenesis

“…Some studies analyzed the prevalence and the risk of developing anxiety in HS. In a systematic review and meta-analysis, a prevalence of 12% (95% CI [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]) with an OR of 1.97 (95% CI [1.65–2.35]) was found [ 21 ]. In another meta-analysis and systematic review, Patel et al found that anxiety was present in 18% of patients with HS versus 7% of the non-HS population, while the risk of developing anxiety was twice that of the second population without HS (OR, 2.00; 95% CI, 1.66–2.42) [ 20 ].…”

“…Hidradenitis suppurativa surgery often requires wide excision with problematic wound closure. A new reconstructive technique is represented by the co-graft Acellular Dermal Matrix (an acellular matrix made by collagen) and the Split Thickness Skin Graft [ 11 , 12 ].…”

Human Acellular Dermal Matrix in Reconstructive Surgery—A Review

“…Since Livesey’s potentially useful concept of ADM [ 14 ], ADM has been used in a different new application like hidradenitis suppurativa surgery [ 47 , 48 ], ADM seems to be a biomaterial with great potential. The place of ADM in surgical specialties will extend, and we are sure that we will see a new surgical procedure with ADM.…”

“…They implanted ADM in four cases followed by flap reconstruction, in two of the cases ADM was used as a skin substitute (biological dressing), and in 1 case ADM application was followed by skin grafts after 22 weeks of placement of the acellular dermal matrix [ 47 ]. However, the first co-graft of ADM and STSG after wide excisions of Hidradenitis suppurativa during one surgical procedure was performed by Gierek et al (2022) [ 48 ]. ADM co-graft and other applications in hidradenitis suppurativa surgery are presented in Figure 4 .…”

Platelet-Rich Plasma and Acellular Dermal Matrix in the Surgical Treatment of Hidradenitis Suppurativa: A Comparative Retrospective Study

“…Available biomaterials have their advantages and disadvantages [ 18 ]. The co-graft of acellular dermal matrix (ADM) and split-thickness skin graft (STSG) has shown good efficacy as an improved treatment for wide HS excision sites [ 19 ]. This study is a presentation of the treatment results of PRP-assisted reconstructive skin flap surgery methods and the results of ADM and STSG co-graft surgery.…”