Complex Wound Management Utilizing an Artificial Dermal Matrix

Abstract

The benefits of the Integra Dermal Regeneration Template in the management of extensive burn injuries have been well documented. Integra can reduce donor- and graft-site scarring and has been reported to be capable of vascularizing over small areas of exposed bone and tendon. Given these potential advantages, we have used Integra for a variety of other reconstruction applications. We performed a retrospective review of patients with complex wounds treated with Integra at our burn center. Integra was used in the management of a variety of wounds, including necrotizing fasciitis, extremity degloving injury, meningococcemia, Marjolin ulcer, postburn lip reconstruction, and fourth-degree burns with exposed bone or tendon. Engraftment rates of Integra and autograft were 98% +/- 4% and 97% +/- 4%, respectively. All areas of graft loss healed without need for regrafting. The benefits of Integra in the management of acute burn wounds can be extended to other traumatic and complex wounds.

Efficacy of the combination of herbal extracts and a silicone derivative in the treatment of hypertrophic scar formation after burn injury

“…These preventions usually include topical medical application, cryotherapy, the use of silicone gel sheets, the injection of steroids, radiotherapy and an early surgical procedure for wound closure. Recent reports have introduced the use of extracts from natural sources such as plant extracts in an attempt to correct these problems (Muangman et al, 2006;Stella et al, 2008;Zurada et al, 2006).…”

Minced Tissue in Compressed Collagen: A Cell-containing Biotransplant for Single-staged Reconstructive Repair

“…The collagen promotes ingrowth of granulation tissue, re-modelling and maturation of extra-cellular matrix 15 . As collagen is degraded, neovascularization and granulation tissue supports the transplanted minced particles that reorganize, migrate and expand [5][6][7]11,16 .…”

Dermal Substitute for Reconstruction of Large Full Thickness Scalp Defect: a Case of Dermal Regeneration without Removal of the Outer Table of the Skull

“…Skin grafts, alone or after the placement of a dermal substitute, allow for better tumor observation, offer a rapid coverage of the wound, and low morbidity [4]. A major limitation is that split-thickness skin grafts and dermal substitutes need a well vascularized recipient bed to survive because of their high metabolism [5,6]. If the periosteum is absent the vascularization of the underlying intact calvarium is insufficient to allow graft survival.…”