Tendon coverage using an artificial skin substitute

Shores, Jaimie T.; Hiersche, M.; Gabriel, Allen; Gupta, Subhas C.

doi:10.1016/j.bjps.2012.05.021

Cited by 56 publications

(39 citation statements)

References 16 publications

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“…In line with Shores et al [12], we did not witness any case of acute complications, i.e., infection of the Integra template or significant skin graft loss during incorporation. Only one patient experienced initial partial take of the STSG over the flexor tendon requiring extended observation and wound therapy for 9 weeks.…”

Section: Discussionsupporting

confidence: 89%

“…Another possibility to even reduce tendon exposure may be the preservation of the deep forearm fascia [22]. Results of previous research are ambiguous: a significant limitation in range of motion at the harvesting site [23] is shown in some and disproven in other studies [12]. Kamal et al showed equal or better clinical outcomes by adopting the suprafascial dissection technique compared to the infrafascial with regard to tendon adhesion (0 vs. 0) and sensory nerve damage at donor site (0 vs. 2), with an equal number of flap failure (1/1) [24].…”

Section: Discussionmentioning

confidence: 99%

“…However, it requires a two-stage procedure before final defect coverage to allow for adequate vascularization of the template [11]. Integra provides an immediate donor site coverage independent of wound size [12]. As an additional benefit, it creates a gliding surface between the underlying structures, e.g., paratenon or nerves and the STSG.…”

Section: Introductionmentioning

confidence: 99%

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Long-term follow-up of donor site morbidity after defect coverage with Integra following radial forearm flap elevation

et al. 2014

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BackgroundThe radial forearm flap (RFF) is known for its excellent and reliable results regarding defect coverage though donor site morbidity represents a persisting problem. Integra is widely used in reconstructive surgery. This study aims to assess long-term outcomes regarding functionality and cosmesis after donor site coverage with respect to esthetic appearance, scar quality, and wrist function as well as ability to work after donor site coverage with Integra and split-thickness skin.MethodsThe prospective follow-up exam, after a mean time of 23.8 months, enrolled 13 patients. Identification of patients’ comorbidities and evaluation of the subjective esthetic outcome, sensibility, cold intolerance, and scar instability was assessed by a questionnaire. In clinics, designed Pinch test assessed scar tissue mobility over the flexor tendons. The Vancouver Scar Scale (VSS) was calculated; wrist function and grip strength were determined.ResultsThe satisfaction score for the esthetic appearance of the donor site was in average 3.42 ± 0.44. Two patients experienced an unstable scar and cold intolerance. The VSS resulted in a value of 4.2 representing a good result. The pinch test revealed an average scar mobility of 8 mm without any tendon adhesions. Active range of motion of the wrist was equal to the non-operated site as was grip strength. The pinch test showed a significant negative correlation with the VSS making it a reliable tool to measure scar quality.ConclusionLong-term results show an esthetic and functional successful defect coverage of the RFF donor site by the use of Integra and split-thickness skin.Level of Evidence: Level IV, therapeutic study.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-term follow-up of donor site morbidity after defect coverage with Integra following radial forearm flap elevation

et al. 2014

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“…[22][23][24] A recent case series of wounds with exposed tendons subsequently covered with Integra demonstrated ultimate skin graft take of 93 percent, with active range of motion of 90 percent of the contralateral side. 25 Integra prevents dessication and provides a scaffold for cellular ingrowth. 26 From a technical standpoint, it is important to ensure a clean wound bed and good hemostasis before Integra application.…”

Section: Nontraditional Option: Integra Followed By Splitthickness Skmentioning

confidence: 99%

Soft-Tissue Coverage of the Hand

Eberlin¹,

Chang²,

Curtin³

et al. 2014

Plastic and Reconstructive Surgery

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Adequate soft-tissue coverage of the hand is paramount to achieve optimal aesthetic and functional results in patients with complex hand defects. In this article, the authors present four illustrative clinical cases and discuss potential reconstructive modalities. For each scenario, two surgical options are discussed: one established and one nontraditional method of reconstruction. The authors' preferred method and technical pearls for execution are presented.

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“…These have the advantage of allowing for harvesting of thinner split-thickness skin grafts, which result in faster donor site healing, and provide a gliding surface for tendon excursion. 15,16 Split-thickness grafts are harvested at least 0.012-inch (0.3-mm) thick and placed as sheet grafts if possible (Fig. 4).…”

Section: Surgical Treatmentmentioning

confidence: 99%