Management of Defects on Lower Extremities with the Use of Matriderm and Skin Graft

Abstract

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.

Retrospective analysis of 56 soft tissue defects treated with one‐stage reconstruction using dermal skin substitutes

“…The clinical results in our 56 cases are similarly promising, and confirm previous findings described by other groups . We treated 36 (64.2 %) patients with soft tissue defects due to traumatic injury, including 26 (46.4 %) individuals who presented after sustaining open fractures, a diagnosis that may be a major indication for the use of dermal skin substitutes in the future.…”

The effect of a collagen-elastin matrix on adhesion formation after flexor tendon repair in a rabbit model

“…To allow for early active motion, the tendon-suture construct needs to be designed to prevent re-rupture or knot unravelling. The initial strength of a tendon repair is roughly proportional to the number of suture strands that cross the repair site [19][20][21][22][23][24]. The most commonly used techniques have involved a two-strand repair.…”

“…Its biocompatibility has been proven allowing for biointegration [18,21]. In application studies, it could be shown that Matriderm Ò provides a persistent sliding layer [18][19][20][21]. This study was designed to examine if the collagen-elastin matrix could be useful to inhibit the formation of fibrotic adhesions after repair of flexor tendon injuries comparing standardized 2-and 4-strand suture techniques.…”

“…None of them has found its way into routine clinical use. Matriderm Ò is a biosynthetic membrane made of collagen and elastin and has successfully used to replace subcutaneous tissue in split skin grafts for burn injuries [18][19][20][21]. Its biocompatibility has been proven allowing for biointegration [18,21].…”

Retrospektive Analyse von56 Weichteildefekten nach einzeitiger Rekonstruktion unter Verwendung von Dermisersatzpräparaten

“…Die klinischen Befunde unserer 56 Fälle sind ähnlich vielversprechend und bestätigen vormals von anderen Gruppen beschriebene Ergebnisse . Wir behandelten 36 Patienten (64,2 %) mit Defektverletzungen aufgrund von Unfallverletzungen, einschließlich 26 Personen (46,4 %), die sich nach offenen Frakturen vorstellten.…”