Successful treatment of complex traumatic and surgical wounds with a foetal bovine dermal matrix

Abstract

A foetal bovine dermal repair scaffold (PriMatrix, TEI Biosciences) was used to treat complex surgical or traumatic wounds where the clinical need was to avoid skin flaps and to build new tissue in the wound that could be reepithelialised from the wound margins or closed with a subsequent application of a split-thickness skin graft (STSG). Forty-three consecutive cases were reviewed having an average size of 79·3 cm(2) , 50% of which had exposed tendon and/or bone. In a subset of wounds (44·7%), the implantation of the foetal dermal collagen scaffold was also augmented with negative pressure wound therapy (NPWT). Complete wound healing was documented in over 80% of the wounds treated, whether the wound was treated with the foetal bovine dermal scaffold alone (95·2%) or when supplemented with NPWT (82·4%). The scaffold successfully incorporated into wounds with exposed tendon and/or bone to build vascularised, dermal-like tissue. The new tissue in the wound supported STSGs however, in the majority of the cases (88·3%); wound closure was achieved through reepithelialisation of the incorporated dermal scaffold by endogenous wound keratinocytes. The foetal bovine dermal repair scaffold was found to offer an effective alternative treatment strategy for definitive closure of challenging traumatic or surgical wounds on patients who were not suitable candidates for tissue flaps.

Indeterminate-Depth Burn Injury—Exploring the Uncertainty

“…FBC has been shown to result in 80% graft take of complex traumatic surgical wounds with subsequent STSG placement. 68 Unlike Integra, it has been shown to result in wound healing without STSG in a patient with mixed full-and partialthickness burn. 69 Of note, the burn wound in this study was assessed clinically as a full-thickness burn; however, subsequent biopsies revealed that there was a mixture of full-and partial-thickness burns in the wound bed.…”

Reconstruction of Extensive Volar Finger Defects with Double Cross-Finger Flaps

“… 5 To increase successful ingrowth of the skin graft, this is usually performed in a staged procedure in combination with negative-pressure wound therapy. 6 Hereby, the ADM is transplanted, and negative-pressure wound therapy is performed for several days to improve vascularization of the ADM before skin transplantation. Despite good functional and aesthetic results, this approach is time consuming and cost intensive.…”

Combined use of fenestrated‐type artificial dermis and topical negative pressure wound therapy for the venous leg ulcer of a rheumatoid arthritis patient

“…The combination therapy of unmeshed artificial dermis and NPWT has been reported to be effective in the treatment of chronic ulcers and complex wounds with exposed tendon or bone . However, meshed artificial dermis would be suitable, especially in complex wounds, because wound exudates and haematoma could be drained from the fenestration . As for the mechanism involved in the combination therapy with artificial dermis and NPWT in vitro, Baldwin et al reported that continuous negative pressure stimulates the migration and proliferation of human microvascular endothelial cells cultured on artificial dermis through the fenestration of the silicone layer .…”