Use of a Permanent Acellular Dermal Allograft in Recessive Dystrophic Epidermolysis Bullosa Involving the Hands

Witt, Peter D.; Cohen, D. Walter; Mallory, Susan B.

doi:10.1001/archderm.135.5.503

Cited by 15 publications

(7 citation statements)

References 25 publications

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“…In these cases, the use of skin graft (splitthickness or full-thickness), cultured keratinocytes, and cellular allograft dermal matrix (such as Apligraf) or acellular biosynthetic material (such as Biobrane or AlloDerm-GBR) has been described in the literature. 7,[16][17][18][19][20][21][22][23][24][25][26] Split-thickness skin grafts (STSG) provide coverage of wide areas, however, availability of healthy skin for autologous grafting and di cult healing at the donor site can be major problems in EB patients. Moreover, split-thickness skin graft usually provides unstable coverage with high risk of early recurrences.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies analyzed the utility of other materials such as autologous and allogenic epidermal keratinocyte grafts, amniotic membrane grafts, and acellular dermal allograft. 20,21,24,25 Although some disadvantages are described such as need autologous STSG harvesting, prolonged time healing, and high costs 20,25 , nevertheless the new dermal support created by the acellular dermal matrix can prevent recurrence of the pseudosyndactylies in the long term. 26 Hand function preservation and the time interval to relapse are the most important parameters in evaluating surgery e cacy.…”

Section: Discussionmentioning

confidence: 99%

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Release of pseudosyndactyly in recessive dystrophic epidermolysis bullosa using a dermal regeneration template glove – the Foggia experience.

Lembo

Parisi

Cecchinov

et al. 2021

Preprint

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BACKGROUNDː Epidermolysis Bullosa (EB) comprises a heterogeneous group of rare genetic diseases associated with skin blistering caused by minimal trauma. A major and common EB subtype, recessive dystrophic EB (RDEB), is characterized by altered wound healing, inflammatory dysbalance and fibrotic changes associated with reduced to absent collagen VII. Because of its exposed position and its continued use in daily activities, the hand is constantly at risk of microtrauma and is therefore one of the organs most affected by the disease with highly disabling deformities that represent a challenging field in hand surgery practice. METHODSː The Authors present their experience in the microsurgical treatment of pseudosyndactylies comparing the classic dressing with vaseline gauze with an innovative “glove protocol” using Integra® dermal regeneration template. The endpoints analyzed were: healing times, hospital stay time, discomfort for the patient, free-recurrence interval, follow-up range and major complications. RESULTSː A total of 34 procedures were performed on 24 RDEB patients with hand deformities. Compared with the dressing with vaseline gauze, microsurgery followed by application of dermal regeneration template gloves allowed a significant reduction of hospital stay, healing time, and dressing pain as well as an increased recurrence-free interval. CONCLUSIONSː The microsurgical approach followed by our new protocol described in the study has been beneficial in providing consistent and successful long-term results for these patients. Key words : Epidermolysis Bullosa, Pseudosyndactyly, Hand, Dermal regeneration template.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Release of pseudosyndactyly in recessive dystrophic epidermolysis bullosa using a dermal regeneration template glove – the Foggia experience.

Lembo

Parisi

Cecchinov

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…In these cases, in literature was described the use of skin graft (split-thickness or full-thickness), cultured keratinocytes, and cellular allograft dermal matrix (such as Apligraf) or acellular biosynthetic material (such as Biobrane or AlloDerm-GBR). 1,2,7,[16][17][18][19][20][21][22][23][24][25][26] Split-thickness skin grafts (STSG) provide coverage of wide areas, however, availability of healthy skin for autologous grafting and di culty healing at the donor site can be major problems in EB patients.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies analyzed the utility of other materials such as autologous and allogenic epidermal keratinocyte grafts, amniotic membrane grafts, and acellular dermal allograft. 20,21,24,25 Although some disadvantages are described such as need autologous STSG harvesting, prolonged time healing, and high costs 20,25 , however it is demonstrated that the new dermal support created by the acellular dermal matrix can prevent recurrence of the pseudosyndactylies in the long term. 26 Hand function preservation and the time interval to relapse are the most important parameters in evaluating surgery e cacy.…”

Section: Discussionmentioning

confidence: 99%

New treatment protocol for pseudosyndactyly in epidermolysis bullosa hand using a dermal regeneration template glove.

Lembo

Parisi

Cecchino

et al. 2020

Preprint

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BACKGROUNDː The Epidermolysis Bullosa (EB) is a rare genetic disease associated with blistering skin caused by minimal trauma. Because of its exposed position and its continued use in daily activities, the hand is constantly at risk of microtrauma and is therefore one of the organs most affected by the disease with highly disabling deformities that represents a challenging field in hand surgery practice.METHODSː The Authors present their experience in the microsurgical treatment of pseudosyndactylies comparing the classic dressing with vaseline gauze with our innovative “glove protocol” using Integra® dermal regeneration template. The endpoints analyzed were: healing times, hospital stay time, discomfort for the patient, free-recurrence interval, follow-up range and major complications.RESULTSː A total of 34 procedures were performed on 24 EB patients with hand deformities. Compared with the dressing with vaseline gauze, microsurgery followed by application of dermal regeneration template gloves allowed a significant reduction of hospital stay, healing time, and dressing pain as well as an increased recurrence-free interval.CONCLUSIONSː The microsurgical approach followed by our new protocol described in the study has been beneficial in providing consistent and successful long-term results for these patients.

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“…Treatment of difficult wounds may involve using artificial skin substitutes [dermal allografts (39), living bi‐layered skin equivalents (e.g., Apligraft) (40)], biologic dressings [amniotic membrane grafting (41)], and growth factors such as platelet derived growth factor.…”

Section: Biologic Dressings and Future Directionsmentioning

confidence: 99%

Principles of Wound Care in Patients with Epidermolysis Bullosa

Lara‐Corrales

Arbuckle

Zarinehbaf

et al. 2010

Pediatric Dermatology

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Epidermolysis bullosa comprises a series of hereditary skin fragility disorders characterized by blister formation in response to minor friction or trauma. Acute and chronic wounds are part of the daily life of many epidermolysis bullosa patients. To offer proper care, health care providers need to understand the wound healing process, recognize the different types of wounds these patients may present, and be able to select among a wide variety of wound care products to optimize healing.

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Use of a Permanent Acellular Dermal Allograft in Recessive Dystrophic Epidermolysis Bullosa Involving the Hands

Cited by 15 publications

References 25 publications

Release of pseudosyndactyly in recessive dystrophic epidermolysis bullosa using a dermal regeneration template glove – the Foggia experience.

Release of pseudosyndactyly in recessive dystrophic epidermolysis bullosa using a dermal regeneration template glove – the Foggia experience.

New treatment protocol for pseudosyndactyly in epidermolysis bullosa hand using a dermal regeneration template glove.

Principles of Wound Care in Patients with Epidermolysis Bullosa

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