Acellular Dermal Matrix to Treat Full Thickness Skin Defects: Follow-Up Subjective and Objective Skin Quality Assessments

Abstract

BackgroundThere are several options for replacement of the dermal layer in full-thickness skin defects. In this study, we present the surgical outcomes of reconstruction using acellular dermal substitutes by means of objective and subjective scar assessment tools.MethodsWe retrospectively reviewed the medical records of 78 patients who had undergone autologous split-thickness skin graft with or without concomitant acellular dermal matrix (CGDerm or AlloDerm) graft. We examined graft survival rate and evaluated postoperative functional skin values. Individual comparisons were performed between the area of skin graft and the surrounding normal skin. Nine months after surgery, we compared the skin qualities of CGDerm graft group (n=25), AlloDerm graft group (n=8) with skin graft only group (n=23) each other using the objective and subjective measurements.ResultsThe average of graft survival rate was 93% for CGDerm group, 92% for AlloDerm group and 86% for skin graft only group. Comparing CGDerm grafted skin to the surrounding normal skin, mean elasticity, hydration, and skin barrier values were 87%, 86%, and 82%, respectively. AlloDerm grafted skin values were 84%, 85%, and 84%, respectively. There were no statistical differences between the CGDerm and AlloDerm groups with regard to graft survival rate and skin functional analysis values. However, both groups showed more improvement of skin quality than skin graft only group.ConclusionThe new dermal substitute (CGDerm) demonstrated comparable results with regard to elasticity, humidification, and skin barrier effect when compared with conventional dermal substitute (AlloDerm).

The Pinking Shears

“…Despite the many documented advantages of autologous split-thickness grafting scar contracture, loss of elasticity and unfavorable aesthetic results remain a considerable problem. 1 The transition between the graft and normal skin is typically very sharp and can frequently be hypertrophic. We describe a novel use of pinking shears to create a serrated edge on both the skin graft and the recipient defect, thereby rendering the transition point between the two less obvious.…”

Progress in development of bioderived materials for dermal wound healing

“…Dermal grafts obtained from human subjects have been used to treat burns and full-thickness skin defects [80, 81]. However, their applicability is limited by their high cost, the limited availability of cadaver skin, and the risk of disease transmission [82].…”

“…The ADM is the remaining ECM of the dermal and basement membranes once the cellular components (the epidermis and the cells of the dermis) have been removed and can provide the mechanical support lacking at the wound site, improve the quality of wound healing, increase the survival rate of the epidermal membrane, and prevent wound contraction and scar formation [ 79 ]. Dermal grafts obtained from human subjects have been used to treat burns and full-thickness skin defects [ 80 , 81 ]. However, their applicability is limited by their high cost, the limited availability of cadaver skin, and the risk of disease transmission [ 82 ].…”

Acellular dermal matrix in premature ejaculation

“…[ 4 ] With this approach, through a short dorsal incision at the base of the penis, the scar is concealed in a crease covered by pubic hair and thus hardly visible. Although a survey conducted by Tealab et al showed that penile augmentation by porcine acellular dermal grafts might negatively affect male sexual status (4 in 18 patients reported decreased penile sensation at 6-month visit), [ 5 ] penile enlargement by implantation of ADM was a safe and effective operation in most of the reports [ 4 , 6 ] and, no major complications occurred in the patients received penile augmentation by ADM. [ 7 ]…”