Application of a paste-type acellular dermal matrix for coverage of chronic ulcerative wounds

Abstract

Dear Editor, We read with substantial interest the article published by Jeon and Kim [1] in the latest issue of Archives of Plastic Surgery. We would like to congratulate the authors for making a fine contribution to the field of chronic wound therapy by introducing the use of paste-type acellular dermal matrix (ADM). We are aware that new solutions are required to address this increasingly prevalent problem, but most of the recently described and highly promising materials for the management of this entity are either still not widely available or need to be investigated in greater depth to determine their utility and specific indications. Therefore, we find it worthwhile to emphasize that this field represents a great area of opportunity for research and will benefit from the participation of all related medical professionals worldwide to improve our patients' outcomes.The treatment of chronic wounds indeed poses a challenge for the plastic surgeon, and ADM represents a promising resource in this context.As mentioned, patients with chronic wounds frequently present with several comorbidities, which are, in our center´s experience, not limited to type 2 diabetes mellitus and peripheral arterial disease. As a referral center, we treat on regular basis patients with several connective tissue disorders, such as systemic lupus erythematosus, rheumatoid arthritis, mixed connective tissue disease, burn sequelae, cancer, and transplant recipients, who regularly receive strong immune suppressors and antimetabolites for their conditions, all of which alter the physiologic mechanisms of wound healing via several pathways.