Single‐stage Matriderm^® and skin grafting as an alternative reconstruction in high‐voltage injuries

Abstract

This article presents a retrospective analysis of a series of nine patients requiring reconstruction of exposed bone, tendons or joint capsules as a result of acute high-voltage injuries in a single burn centre. As an alternative to free tissue transfer, the dermal substitute Matriderm(®) was used in a one-stage procedure in combination with split-thickness skin grafts (STSG) for reconstruction. Nine patients, in the period between 2005 and 2009 with extensive high-voltage injuries to one or more extremities which required coverage of exposed functional structures as bone, tendons or joint capsule, were included. A total of 11 skin graftings and 2 local flaps were performed. Data including regrafting rate, complications, hospital stays, length of rehabilitation and time until return to work were collected. Eleven STSG in combination with Matriderm(®) were performed on nine patients (success rate 89%). One patient died. One patient needed a free-flap coverage as a secondary procedure. The median follow-up was 30 months (range 6-48 months). The clinical results of these nine treated patients concerning skin-quality and coverage of exposed tendons or joint capsule were very good. In high-voltage injuries free-flap failure occurs between 10% and 30% if performed within the first 4-6 weeks after trauma. The use of single-stage Matriderm(®) and skin grafting for immediate coverage described in this article is a reliable alternative to selected cases within this period.

Management of neck contractures by single-stage dermal substitutes and skin grafting in extensive burn patients

“…Matriderm is a highly porous dermal substitute, which consists of a collagen matrix cross-linked to an elastin hydrolysate. It may be employed in a single-stage procedure with immediate STSG [15,16]. One animal study reported that Matriderm showed a better rate of integration compared to other dermal substitutes [17].…”

The effect of collagen–chitosan porous scaffold thickness on dermal regeneration in a one-stage grafting procedure

“…Thicker composite grafts have displayed less contracture formation, ultimately with an optimum cosmetic and functional outcome. Some dermal substitutes (e.g., , 1-mm -thick Matriderm ® , a bovine-based collagen I, III, and V and elastin hydrolysate dermal substitute) have also resulted in good clinical outcomes with a one-stage procedure (Haslik et al, 2007;Ryssel et al, 2008;Ryssel et al, 2010). Recently, a single-layer product, Integra ® (IDRT-SL ® ), was introduced for one-stage closure of deep facial surgical wounds in elderly multimorbid patients; studies have shown promising graft-take rates and good functional and cosmetic outcomes (Koenen et al, 2011).…”

Development of Artificial Dermis Using 3D Electrospun Silk Fibroin Nanofiber Matrix

“…24 However, its thickness is thin, only 1 mm; thus, it should be covered with split thickness skin grafts, causing morbidity of the donor site. [25][26][27][28][29] Furthermore, there are risks of allergic reaction and infection caused by bovine collagen. To overcome these challenges, alternative artificial scaffolds based on poly(ethylene glycol), poly(lactic acid), polycaprolactone, polyphosphates, ceramics and metals have been developed.…”