The use of dermal regeneration template for treatment of complex wound with bone/tendon exposed at the forearm and hand, a prospective cohort study

Lv, Zhenmu; Yu, Lili; Wang, Qiusheng; Jia, Rui; Ding, Wenyuan; Shen, Yong

doi:10.1097/md.0000000000017726

Cited by 15 publications

(16 citation statements)

References 22 publications

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“…From the first studies of Suzuki on the possible applications of the new substitute [21], several authors produced about a dozen publications on its use, generally posttrauma [22][23][24][25][26][27][28], or for the correction of burn scars [29][30][31], or postremoval of giant nevi [32,33], or for ulcers repair [34,35].…”

Section: Discussionmentioning

confidence: 99%

Utility of a New Artificial Dermis as a Successful Tool in Face and Scalp Reconstruction for Skin Cancer: Analysis of the Efficacy, Safety, and Aesthetic Outcomes

Lembo

Cecchino

Parisi

et al. 2020

Dermatology Research and Practice

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Radical ablative surgery is the gold standard treatment of head skin cancer. The authors expose their experience with a new artificial dermis (Pelnac®), analyzing retrospectively the overall morbidity and aesthetic outcomes. 16 consecutive patients underwent two surgical procedures under local anesthesia. The first involved the tumor removal and application of the ADM. In the second, the exposed tissue was covered with a split-thickness skin graft. On follow-up (6 months), tumor recurrences, quality of scars (using the Vancouver Scar Scale), and patient reported outcomes (using FACE-Q Skin Cancer Module) were evaluated. 10 were males and 6 females, with a mean age of 73 years (61–89). The follow-up ranged from 12 to 48 months (mean: 30). The sites of skin tumor were scalp (12 cases), forehead (2), cheek (1), and zygomatic area (1). Nine patients underwent previous local surgery; two received radiotherapy. The average length of hospital stay was 3.2 days. The mean surface area of the defect was 59.15 cm2 (16.9–89.5). In three cases, the surgical bed was bone without periosteum. The malignant tumors excised were basal cell carcinoma (68.75%), squamous cell carcinoma (18.75%), malignant melanoma (6.25%), and sarcoma (6.25%). The mean operating time was 41 minutes for the first operation (25–55) and 34 for the second (25–48). No significant problems were observed and 15 patients (93.75%) had 100 percent intake of graft. The mean time of healing was 39 days (32–45). At 6 months post-op, no tumor recurrence. Satisfactory cosmetic and functional results were obtained in all patients as shown by the VSS Scale and FACEQ skin cancer module mean scores. We believe that the artificial dermis is a reliable alternative to flaps and should be considered an excellent option in head reconstruction for skin cancer, especially in critical patients (old, with large and deep defects, with recurrent tumors, required radiotherapy).

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Section: Discussionmentioning

confidence: 99%

Utility of a New Artificial Dermis as a Successful Tool in Face and Scalp Reconstruction for Skin Cancer: Analysis of the Efficacy, Safety, and Aesthetic Outcomes

Lembo

Cecchino

Parisi

et al. 2020

Dermatology Research and Practice

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“…12 Tissue scaffolds offered an alternative, simpler, and lessinvasive way of reconstructing severe wounds with mini-mum morbidity than reconstructive flaps. 5,13 Commercially available tissue scaffolds include biological and synthetic varieties, and all have been reported to be efficacious. 13 The bilayered synthetic tissue scaffold used here comprises of an inner 2-mm-thick absorbable polyurethane foam, covered on the outside with a semipermeable polyurethane film.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] Negative-pressure wound therapy (NPWT) and biomaterial application followed by skin grafting are recent additions. 2,5 Striking a middle ground between these two approaches, minimally invasive reconstruction focuses on accurate conservative debridement performed every 5 days. Regenerative therapy is combined to prevent necrosis of soft tissues with suspicious viability while simultaneously guarding against infections.…”

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confidence: 99%

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Minimally Invasive Successful Reconstruction of a Severely Traumatized Upper Extremity Using Platelet-Rich Plasma and Tissue Scaffold: A Case Report

Saha¹

2022

Surg J (N Y)

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Minimally invasive reconstruction combines principles of tissue engineering and regenerative medicine for healing complex wounds. This approach was successfully demonstrated on a 64-year-old diabetic and hypertensive male patient, who was brought unconscious to our emergency after surviving an automobile collision with severe brain and right-dominant upper extremity injuries. Uncontrolled hyperglycemia, severe anemia, diffuse axonal brain injury, wrist drop, and loss of thumb extension and abduction were noted. Extensive degloving, skin necrosis, extensor and flexor forearm muscle crush injuries, and ruptured extensor tendons were observed. Serial wound debridement combined with platelet-poor plasma injection into the muscles, platelet-rich plasma injections into the tendons and subcutis, and low-negative pressure wound therapy were performed sequentially to salvage the injured soft-tissues. Improvements were noticed during the second exploration after 5 days. Surviving muscles showed adequate vascularization and revival of innervation during the third exploration after another 5 days. Thereafter, absorbable synthetic tissue scaffold was applied over a sizeable 270 cm2 wound as a flap-alternative. Tissues regenerated well within the scaffold during the next 2 months, halving the wound area to 132 cm2. A thick split-skin graft was applied over the remaining granulating neodermis, which “took” completely. Six months postoperatively, the patient regained most hand functions and performed all activities satisfactorily, while the grafted area appeared almost identical to surroundings. Minimally invasive reconstruction thus produced satisfying results with fewer shorter simpler surgeries, minimal anesthesia, short-duration hospitalization, lower health care costs, lesser risks, and excellent patient-reported outcomes.

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“…42,47,48 The esthetical and functional results and satisfaction among patients treated in this study with or without skin graft are superimposable. In 2013, Jacoby et al 47 In the past, authors of this article also used porcine xenograft 49,50 to treat finger tissue loss with very good results, until religious aspects raised some issues (eg, Muslim patients refusing to be treated with porcine derivates).…”

Section: Discussionmentioning

confidence: 99%

Matriderm dermal substitute in the treatment of post traumatic hand’s fingertip tissue loss

Fulchignoni

Rocchi

Cauteruccio

et al. 2021

J of Cosmetic Dermatology

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Introduction: Treatment of fingers tissue loss is particularly challenging as it often necessitates advanced reconstructive techniques such as flaps or grafts, with esthetic and functional results that are not always as good as hoped for, with long healing times. Recently, along with tissue engineering development, numerous types of dermal substitute have been commercialized, with promising possibilities of treatment in finger tissue loss. In the author's unit, Matriderm ® is the most commonly used dermal substitute. As described by the manufacturer, this scaffold is designed to be covered with a split-thickness skin graft. In using a two-step procedure, the authors realized that in most cases of fingertips injuries, at three weeks follow-up, the wound appeared in an advanced state of healing, which permitted to avoid grafting. Material And Methods: Between October 2017 and October 2018, 27 fingers have been included in this study. Patients have been divided in two groups: those treated with Matriderm ® alone (15 fingers) and those who had a skin graft three weeks after the first surgery (12 fingers). At the 6-month follow-up, authors evaluated the esthetic results with the Vancouver Scar Scale (VSS), the functional results with Quick Disability of the Arm, Shoulder and Hand (qDASH) score, and sensibility by the mean of two-point discrimination test (2-PD).Results: All outcomes were overlapping in patients treated with or without skin graft: mean VSS was 2.3, mean qDASH was 13.3, and mean 2-PD was 7.7 mm. Conclusions:The results obtained allow to consider Matriderm ® , used also without skin graft coverage, as a valid solution for treatment of fingertip tissue loss.

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The use of dermal regeneration template for treatment of complex wound with bone/tendon exposed at the forearm and hand, a prospective cohort study

Cited by 15 publications

References 22 publications

Utility of a New Artificial Dermis as a Successful Tool in Face and Scalp Reconstruction for Skin Cancer: Analysis of the Efficacy, Safety, and Aesthetic Outcomes

Utility of a New Artificial Dermis as a Successful Tool in Face and Scalp Reconstruction for Skin Cancer: Analysis of the Efficacy, Safety, and Aesthetic Outcomes

Minimally Invasive Successful Reconstruction of a Severely Traumatized Upper Extremity Using Platelet-Rich Plasma and Tissue Scaffold: A Case Report

Matriderm dermal substitute in the treatment of post traumatic hand’s fingertip tissue loss

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