Soft Tissue Reconstructions with Dermal Substitutes Versus Alternative Approaches in Patients with Traumatic Complex Wounds

Abstract

The use of dermal substitutes is considered an effective treatment in several pathologies involving skin damage, mainly extensive burns and trauma. Treatment alternatives entail performing flaps or autografts. The purpose of this cross-sectional study is to assess the clinical effects and costeffectiveness of dermal substitutes in surgical procedure in complex wound healings of adult trauma patients. The study includes 52 patients who received dermal substitutes (n=25) between 2007 and 2012 and patients treated between 2006 and 2011 who received standard treatment (n=27). All patients presented with posttraumatic soft tissue defects with bone and/or tendon exposure. Differences in costs, mean differences in Euros and Euros per square centimeter, and clinical data were collected as outcome measures. Pearson's correlations were used to assess the relationship between total costs with sociodemographic data and clinical services to different healthcare providers (clinical data and costs were recorded for both groups). No relevant differences on acceptance rates were noticed amongst groups. Surgery costs were shown to be significantly reduced in the dermal substitutes group (P<0.01) even though total costs (surgery+hospitaliza-tion) did not exhibit a significant difference. Surgical time was significantly reduced in the dermal substitutes group (1.81 min/cm 2 lesions) as compared with the standard group (6.08 min/cm 2 lesions). The current study suggests that not only clinical but also possible economic and logistical advantages in choosing dermal substitutes may exist.

Versatile use of dermal substitutes: A retrospective survey of 127 consecutive cases

“…Furthermore, not only clinical but also possible economic advantages in choosing dermal substitutes may exist, as surgical costs and surgical time are lower than in traditional reconstructive procedures. [ 10 ]…”

Viable intact cryopreserved human placental membrane for a non-surgical approach to closure in complex wounds

“…23 Although acellular dermal matrices (ADM) applications can initially protect bone and tendon structures, they do not represent a singular treatment option for definitive wound closure. 3,[6][7]12,23,29 The full-thickness reconstruction of such complex wounds requires expedited treatment in order to prevent ongoing tissue loss or patient disability. All 12 wounds (100%) demonstrated closure in a mean time of 10 weeks with a mean number of 8.1 graft applications.…”

Use of MatriDerm® (skin substitute) and split skin graft in one stage in wound healing of exposed tibia without periosteum in two patients

“…Small wound devoid of any vasculature is covered easily by providing a scaffold through a skin substitute which gets vascularised at a faster rate to form a vascularised bed on which skin graft takes up easily. 1,2 In one study two cases out of six were successful. 1 Both cases of two centimetres and four centimetres breadth by us had been successful.…”