Human Acellular Dermal Matrix is a Viable Alternative to Autologous Skin Graft in Patients with Cutaneous Malignancy

Abstract

Skin substitutes have shown success in complex wound reconstruction. We evaluate the use of a human acellular dermal matrix (ADM) as a viable alternative to autologous skin grafting for defects secondary to skin cancer excision. An institutional review board–approved, retrospective review of ADM-reconstructed defects secondary to skin cancer excision between 2012 and 2018 was conducted. ADM was indicated in patients with preclusive factors for general anesthesia, protracted procedure time, reluctance for additional donor site wound, and personal choice. We reviewed defect characteristics, healing time, postoperative outcomes, and patient demographics. The 228 participants (151 males, 77 females) had a median age of 72 years (range, 29–95 years), with melanoma diagnosed in 113 (49.6%), squamous cell carcinoma in 61 (26.8%), and basal cell carcinoma in 28 (12.2%) patients. The median interval to complete epidermal coverage was 42 days, with graft failure evident in six patients (2.6%). ADM is a viable, low-morbid alternative for reconstruction of defects secondary to skin cancer excision, with no donor site morbidity. With exception to complete healing time, outcomes are similar to those of autologous grafting.

Use of Composite Acellular Dermal Matrix-Ultrathin Split-Thickness Skin in Hand Hot-Crush Injuries: A One-Step Grafting Procedure

“…In recent years, ADM graft combined with ultrathin STSG is a common technique in complex wounds of hand hot-crush injuries. The efficacy and advantages of ADM have been well documented [ 6 – 9 , 18 , 19 ]. This technique allows for neovascularised tissue to form overexposed or denuded structures within these wounds, creating a more robust vascularised tissue bed for neovascularisation of subsequently placed skin grafts [ 20 ].…”

Deep burn surgery of the whole dorsum of the hand: Composite skin grafting over acellular dermal matrix versus thick split‐thickness skin grafting

“…20 Some authors reported that ADM was used for the reconstruction of defects secondary to skin cancer excision with no donor site morbidity; the median interval to complete wound healing was 42 days, and the rate of graft failure was 2.6%. 21 Pan et al used composite graft with ADM to treat 19 cases of burn or scar wounds and reported a satisfactory long-term follow-up appearance of the skin donor site. 22 Li et al retrospectively evaluated the outcomes of the co-grafting ADM with autologous thin split-thickness skin for the wound coverage in burn patients and identified acceptable aesthetic outcomes and less scar hyperplasia at the donor site.…”

Membranous Extracellular Matrix-Based Scaffolds for Skin Wound Healing

“…Produced from human or animal skin, ADM is favorable for full-thickness skin wound healing and can reduce scar tissue formation [21,[30][31][32]. After transplantation in the wound bed, ADM enhances the synthesis of hyaluronic acid and induces wound angiogenesis [29,33,34].…”