One-stage reconstruction of soft tissue defects with the sandwich technique: Collagen-elastin dermal template and skin grafts

Abstract

Background:A full-thickness soft tissue defect closure often needs complex procedures. The use of dermal templates can be helpful in improving the outcome.Objective:The objective was to evaluate a sandwich technique combining the dermal collagen–elastin matrix with skin grafts in a one-stage procedure.Materials and Methods:Twenty-three patients with 27 wounds were enrolled in this prospective single-centre observational study. The mean age was 74.8 ± 17.2 years. Included were full-thickness defects with exposed bone, cartilage and/ or tendons. The dermal collagen–elastin matrix was applied onto the wound bed accomplished by skin transplants, i.e. ‘sandwich’ transplantation. In six wounds, the transplants were treated with intermittent negative pressure therapy.Results:The size of defects was ≤875 cm2. The use of the dermal template resulted in a complete and stable granulation in 100% of wounds. Seventeen defects showed a complete closure and 19 achieved a complete granulation with an incomplete closure. There was a marked pain relief. No adverse events were noted due to the dermal template usage.Conclusions:Sandwich transplantation with the collagen–elastin matrix is a useful tool when dealing with full-thickness soft tissue defects with exposed bone, cartilage or tendons.

Elastin-PLGA hybrid electrospun nanofiber scaffolds for salivary epithelial cell self-organization and polarization

“…Additionally, several research groups have introduced elastin for tissue engineering applications, where it has demonstrated promising results for the regeneration of various tissues. Elastin promoted skin regeneration [37–39], in vivo -like organization of hepatocytes [40] and elasticity for blood vessel engineering [41–52]. …”

Scalping Surgery – Dermatologic Indications beyond Curative Primary Skin Cancer Surgery

“…The use of a dermal template has been shown to increase skin graft survival and improve the mechanical quality of the transplant after healing [ 3 - 7 ]. We employed the sandwich technique with a reconstituted elastin-collagen matrix covered by meshed skin graft in a single operation [ 6 ].…”

Surgical therapy by sandwich transplantation using a dermal collagen-elastin matrix and full thickness split grafts and gait rehabilitation with individualized orthesis

“…[49] In contrast to superficial removal of hyperkeratotic horny layer the deep excision of the lesions down to the muscle fascia resulted in a rapid pain relief. In order to improve early rehabilitation in our adolescent boy a specifically tailored KAFO moulded orthosis was employed.…”

“…Details of this technique have been described elsewhere. [4] In the present case we used the 1 mm thick dermal template dry not reconstituted before grafting [Figure 2a–c]. After graft take a foot-and-lower-leg (knee-ankle foot orthosis-KAFO) moulded orthosis was adjusted for the boy to support normal biomechanics of the feet and ankle during the rehabilitation process.…”