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

Abstract

In cases where plastic surgery is unavailable or undesirable, the use of dermal skin substitutes in combination with split-thickness skin grafting represents a promising alternative for covering wounds associated with soft tissue defects.

Long-term experience with a collagen-elastin scaffold in combination with split-thickness skin grafts for the treatment of full-thickness soft tissue defects: improvements in outcome—a retrospective cohort study and case report

“…With the combination of debridement and NPWT prior to the skin grafting, we could further achieve a relevant reduction of the bacterial load in the treated defects of all three different injury groups, which is in accordance with the results of other groups [20,[24][25][26][27][28][29]. But not all defects were free of pathogens when we performed the skin grafting augmented with Matriderm®, which is in stark contrast to the methods described by other studies [2,30]. In nine cases, we performed the final wound closure in wounds, which were not yet free of pathogens, what did not seem to have a negative influence on the healing as those patients showed good long-term results with a reduced duration of hospitalization and number of surgical procedures.…”

“…The great advantages of Matriderm® as a product compared to other dermal regeneration substitutes such as the dermal regeneration template Integra® (Integra LifeSciences, 1100 Campus Road, Princeton, NJ, 08,540) are first of all the possibility of a one-step approach [2,23] and a higher graft take rate [21], which leads to shorter duration of hospitalization and a reduction of surgical procedures required. Also, compared to much more complex and timeconsuming procedures promoting dermal regeneration such as keratinocytes cultures [33], Matriderm® is our preferred choice due to time efficiency, costs, and functional outcome.…”

“…When primary closure is not feasible, more complex procedures such as split-thickness skin grafts or even fasciocutaneous/microvascular free flaps will be necessary. The split-thickness skin grafts often only provide unsatisfactory results in terms of mechanical stability, flexibility, and cosmetics due to insufficient underlying dermal tissue [2][3][4][5][6], while flap surgery is a more complex procedure with higher risks of complications and morbidity at acceptor side as well as donor side. Moreover, a dedicated plastic surgery department is not widely available in most regional hospitals [2].…”

Biological dermal templates with native collagen scaffolds provide guiding ridges for invading cells and may promote structured dermal wound healing

“…Importantly, clinical outcomes from the use of epidermal and dermal skin substitutes show that they are promising adjunctive tools for addressing soft tissue defects and have improved outcomes in reconstructive procedures . Other clinical studies suggest that the use of dermal skin substitutes may be an alternative for flaps, or may be suitable for coverage of radial flap donor sites . Thus, the experimental data confirmed that native collagen scaffolds provide desirable biomechanical, biochemical, and cell biological properties and represent a class of skin substitutes with superior tissue regeneration properties.…”

Salvage of a mangled limb with Matriderm® augmented split‐skin grafting and maggot biodebridement

“…Min et al found more similar tones of skin color compared to adjacent unaffected when mesh grafts were augmented with MD in comparison with skin grafting alone. 34 Furthermore, positive effects on sensory function in the augmented area were reported by Watfa et al 35 Another technical advantage of Matriderm ® compared to most other dermal substitutes is the possibility of a one-step approach 2,34 leading to a reduction of surgical procedures and shorter duration of hospitalization, thereby reducing the cost of hospitalization. Despite our efforts, the patient developed a chronic wound in the area of the Achilles tendon, where the first attempt of Matriderm ® augmented skin grafting failed.…”