Role of acellular dermal matrix allograft in minimal invasive coverage of deep burn wound with bone exposed – case report and histological evaluation

Gáspár, Krisztián; Erdei, Irén; Péter, Zoltán; Dezső, Balázs; Hunyadi, J.; Juhász, István

doi:10.1111/j.1742-4801.2006.00175.x

Cited by 14 publications

(7 citation statements)

References 21 publications

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“…The resulting neodermis is soft, pliable resembling normal skin. In two early cases the Alloderm containing sandwich graft was applied to the decorticated bone of the scapula (unpublished case) and of the proximal third of the tibia [25]. In both cases, a vital neodermis was the result, that could be easily wrinkled and provided protective support to the overlaying epidermis.…”

Section: Discussionmentioning

confidence: 99%

“…The epidermis had normal structure and keratinisation, with apparent cell proliferation (indicated by Ki67 mAb expression). The Alloderm implant converted into a compact, functionally and morphologically live neodermis as an interconnection between the epidermal layer of the skin and the underlying bony tissue [25]. In the opinion of the authors, the easy, one-step procedure of Alloderm grafting with a simultaneous thin STSG overlay is an ideal, minimally invasive procedure in case of joint contractures, delivering in most cases superior or comparable results to complicated skin or fasciocutaneous flaps without the associated donor site morbidity.…”

Section: Discussionmentioning

confidence: 99%

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Long‐Term Followup of Dermal Substitution with Acellular Dermal Implant in Burns and Postburn Scar Corrections

Juhász

Kiss

Lukács

et al. 2010

Dermatology Research and Practice

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Full-thickness burn and other types of deep skin loss will result in scar formation. For at least partial replacement of the lost dermal layer, there are several options to use biotechnologically derived extracellular matrix components or tissue scaffolds of cadaver skin origin. In a survey, we have collected data on 18 pts who have previously received acellular dermal implant Alloderm. The age of these patients at the injury varied between 16 months and 84 years. The average area of the implants was 185 cm2. Among those, 15 implant sites of 14 patients were assessed at an average of 50 months after surgery. The scar function was assessed by using the modified Vancouver Scar Scale. We have found that the overall scar quality and function was significantly better over the implanted areas than over the surrounding skin. Also these areas received a better score for scar height and pliability. Our findings suggest that acellular dermal implants are especially useful tools in the treatment of full-thickness burns as well as postburn scar contractures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Long‐Term Followup of Dermal Substitution with Acellular Dermal Implant in Burns and Postburn Scar Corrections

Juhász

Kiss

Lukács

et al. 2010

Dermatology Research and Practice

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“…In the past, free flaps were commonly used for reconstruction, but there has been a trend toward simpler methods such as local flaps and skin grafts. Skin grafts, often combined with dermal substitutes [8,9,[14][15][16][17] or muscle flaps [18][19][20][21] have been reported in several studies. These shifts have been attributed to the early involvement of plastic surgeons [22] as a result of a reduced risk of complications.…”

Section: Discussionmentioning

confidence: 99%

One-stage reconstruction of extensive exposed tibia on malnourished patient using single-layer Integra and amino acid supplements: A case report and literature review

Lee,

Lin

2024

Medicine

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Rationale: Extremity injuries resulting from motor vehicle collisions, especially those leading to bone-exposed wounds, present challenges for achieving effective wound coverage. Such injuries are susceptible to complications including infections, osteomyelitis, and unexpected amputations due to inadequate blood supply. Severe traumatic degloving injuries often entail damage to the surrounding blood vessels, making local or free flaps impractical choices in many cases. Consequently, treatment options may vary based on distinct clinical scenarios, with no standardized guidelines available. Our study introduces an integrated approach utilizing dermal substitutes and skin grafts as a safer treatment modality for managing large-area tibial exposure resulting from traffic accidents. Patient concerns: A 66-year-old male with a compromised nutritional status was struck by a car while riding a motorcycle. Previous attempts using double-layer Integra and negative pressure wound therapy (NPWT) for two-stage reconstruction have been unsuccessful. Diagnoses: Computed tomography imaging studies revealed multiple comminuted and displaced fractures involving the left femoral shaft, left proximal tibia, left patella, and proximal fibula, as well as a fracture of the right fibular shaft and an avulsion fracture of the right distal medial femur. The patient’s condition corresponded to Type 3B in the Gustilo classification for open fractures, and the patient had an Injury Severity Score of 25. Interventions: We applied a one-stage reconstruction involving single-layer Integra, split-thickness skin grafts, NPWT, and nutritional supplements containing various amino acids. Outcomes: By implementing an integrated treatment approach and providing diligent wound care over a total of 2 months, the patient achieved successful healing and expressed satisfaction with the postoperative results. Lessons: This study offers insights into the effectiveness of employing one-stage reconstruction for traumatic injuries with extensive exposed tibias. In addition, it underscores the impact of a patient’s nutritional status on wound healing and introduces a potential solution for similar challenging cases.

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“…14 The dermal matrix has been described as a good alternative in complex cranial reconstructions after oncological resection and post-traumatic defects with exposed bone or dura. 15,16 MatriDerm is a 3-dimensional matrix composed of native, structurally intact collagen fibrils and elastin for supporting dermal regeneration. The collagen is obtained from the bovine dermis and contains the dermal type I, III, and V collagens.…”

Section: Discussionmentioning

confidence: 99%

Artificial Dermis and Human Recombinant Epidermal Growth Factor Application for the Management of Critical Size Calvarial Defect

Çiçek,

Filinte,

Başak

et al. 2024

Journal of Craniofacial Surgery

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Restoration of the 3-dimensional structure of the facial and calvarial skeleton after trauma or ablative oncologic surgeries serves as a framework for soft tissue reconstruction. In the present study, the authors aimed to evaluate the osteogenic effect of artificial dermis and epidermal growth factor treatment in critical-sized calvarial defects, which cannot be healed spontaneously. 8 mm calvarial defects were created in 28 male rats and filled with the artificial dermis, the artificial dermis and growth factor, growth factor or left untreated. Atomic absorption spectrometry was used to determine the amount of calcium, scanning electron microscopy was used to show the bone tissue in 3 dimensions, and immunohistochemistry was used to assess the bone formation and cell density. Histologic evaluation at 6 weeks showed incomplete bone regeneration in all groups. No statistical differences were found between the groups with regard to their scores for the following: inflammation, new bone formation, osteocyte density, resorption of bone at the edges of the defect, or fibrous tissue formation in the defect area. In conclusion, the predictability of bone formation in critical-size defects is not clear. Contrary to popular belief, the combined use of epidermal growth factor with artificial dermis or alone did not enhance the potential for osseous healing.

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Role of acellular dermal matrix allograft in minimal invasive coverage of deep burn wound with bone exposed – case report and histological evaluation

Cited by 14 publications

References 21 publications

Long‐Term Followup of Dermal Substitution with Acellular Dermal Implant in Burns and Postburn Scar Corrections

Long‐Term Followup of Dermal Substitution with Acellular Dermal Implant in Burns and Postburn Scar Corrections

One-stage reconstruction of extensive exposed tibia on malnourished patient using single-layer Integra and amino acid supplements: A case report and literature review

Artificial Dermis and Human Recombinant Epidermal Growth Factor Application for the Management of Critical Size Calvarial Defect

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