One Stage Integra and Skin Grafting of Full-Thickness Human Wounds

A New Human-Derived Acellular Dermal Matrix for 1-Stage Coverage of Exposed Tendons in the Foot

“…In addition, with the application of the NPWT, "the composite of MODA and STSG" is stabilized by removing the hematoma or seroma under the skin, and MODA facilitates the imbibition, revascularization, and attachment of the graft, thus increasing the success of the single-stage procedure. [10][11][12][15][16][17][18][19][20][31][32][33]39,[43][44][45][46][47] During the healing process and tissue remodeling, the progressive degradation of the scaffold releases molecules that also play a role in determining the recruitment and proliferation of appropriate cell types justifying the postoperative results shown in our patient. 65,66 MODA also shows some useful characteristics making this device very manageable and easy to use: it presents no orientation, both sides potentially being positioned in direct contact with the implant; it is extremely resistant and flexible and can be easily shaped and tailored for any specific use; and the surgeon only needs to rinse it in saline solution before use to remove any trace of the preservation fluid.…”

“…Combined NPWT use may facilitate this 1-step procedure, reducing the main factors related to STSG loss. [10][11][12][15][16][17][18][19][20][31][32][33]39,[43][44][45][46][47] Whereas this may eventually emerge as a promising treatment option, current clinical data regarding dermal substitutes are limited. [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] At present, H-ADMs are the most widely described and studied preparations and AlloDerm is the most popular and widely used option for skin defects.…”

“…[10][11][12][15][16][17][18][19][20][31][32][33]39,[43][44][45][46][47] Nowadays, there exists a wide choice of available ADMs, but only meager data with a high level of evidence have been published to directly compare these products. [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] Human-derived ADMs (H-ADMs) are the most described in the literature 26,[48][49][50][51] and are used as scaffolds allowing new tissue ingrowth, adding structural support to soft tissues, improving the structure of the dermis, and contributing to wound healing as well as reducing scar contracture. 19, According to European legislations (European Community [EC] Directive 2004/23/EC), companies producing H-ADMs outside the EC are not allowed to commercialize them in Europe, H-ADMs being "human products" and not "medical devices," as ruled by European legislations on transplants.…”