Strategies for extremity reconstruction with exposed bones and tendons using acellular dermal matrices: concept of sequential vascularization

Abstract We report 3 cases of patients treated with Bilayer Wound Matrix over exposed structures. In all patients, dermal matrices revascularization occurred sequentially over the course of 6–12 weeks, leading to successful wound closure. Acellular dermal matrices allow more difficult areas with poor vascularity to be covered from the ‘inside-out’.

[1]  C. Hirche,et al.  Negative pressure wound therapy as an accelerator and stabilizer for incorporation of artificial dermal skin substitutes - A retrospective, non-blinded, and non-randomized comparative study. , 2020, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[2]  R. Datiashvili,et al.  Treating Wounds With an Avascular Component With a Dermal Regenerative Template. , 2020, Wounds : a compendium of clinical research and practice.

[3]  L. Levin,et al.  Indications and Limitations of Bilayer Wound Matrix–Based Lower Extremity Reconstruction: A Multidisciplinary Case-Control Study of 191 Wounds , 2000, Plastic and reconstructive surgery.

[4]  V. Strugala,et al.  Meta-Analysis of Comparative Trials Evaluating a Prophylactic Single-Use Negative Pressure Wound Therapy System for the Prevention of Surgical Site Complications , 2017, Surgical infections.

[5]  E. R. Brechtbühl,et al.  Dermal Substitutes Use in Reconstructive Surgery for Skin Tumors: A Single-Center Experience , 2017, International journal of surgical oncology.

[6]  N. Robert Negative pressure wound therapy in orthopaedic surgery. , 2017, Orthopaedics & traumatology, surgery & research : OTSR.

[7]  Alex K. Wong,et al.  Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature , 2016, Plastic and reconstructive surgery. Global open.

[8]  R. Kirsner,et al.  A Review of Cellular and Acellular Matrix Products: Indications, Techniques, and Outcomes , 2016, Plastic and reconstructive surgery.

[9]  K. Chung,et al.  A clinical trial of Integra Template for diabetic foot ulcer treatment , 2015, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[10]  A. Souéid,et al.  The role of dermal regeneration template “Integra®” in reconstructive skin cancer surgery , 2013, European Journal of Plastic Surgery.

[11]  E. Yeong,et al.  The Treatment of Bone Exposure in Burns by Using Artificial Dermis , 2012, Annals of plastic surgery.

[12]  Subhas C. Gupta,et al.  Tendon coverage using an artificial skin substitute. , 2012, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[13]  C. Attinger,et al.  Wound Healing in the Upper and Lower Extremities: A Systematic Review on the Use of Acellular Dermal Matrices , 2012, Plastic and reconstructive surgery.

[14]  C. Attinger,et al.  The New Reconstructive Ladder: Modifications to the Traditional Model , 2011, Plastic and reconstructive surgery.

[15]  J. Geh,et al.  Experience of Integra(®) in cancer reconstructive surgery. , 2010, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[16]  Xin Chen,et al.  Management of wounds with exposed bone structures using an artificial dermis and skin grafting technique. , 2010, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[17]  J. Taras,et al.  Acellular dermal regeneration template for soft tissue reconstruction of the digits. , 2010, The Journal of hand surgery.

[18]  V. Casoli,et al.  A skin substitute (Integra) in a successful delayed reconstruction of a severe injured hand. , 2008, Burns : journal of the International Society for Burn Injuries.

[19]  D. Herndon,et al.  Longitudinal assessment of Integra in primary burn management: A randomized pediatric clinical trial* , 2007, Critical care medicine.

[20]  J. Jeng,et al.  Seven Years' Experience With Integra as a Reconstructive Tool , 2006, Journal of burn care & research : official publication of the American Burn Association.

[21]  B. Brigman,et al.  Stacking of a dermal regeneration template for reconstruction of a soft-tissue defect after tumor excision from the palm of the hand: a case report. , 2005, The Journal of hand surgery.

[22]  Subhas C. Gupta,et al.  Artificial Dermis as an Alternative for Coverage of Complex Scalp Defects following Excision of Malignant Tumors , 2005, Plastic and reconstructive surgery.

[23]  P. Glat,et al.  The use of a dermal regeneration template (Integra) for acute resurfacing and reconstruction of defects created by excision of giant hairy nevi. , 2004, Plastic and reconstructive surgery.

[24]  N. Moiemen,et al.  Reconstructive Surgery with a Dermal Regeneration Template: Clinical and Histologic Study , 2001, Plastic and reconstructive surgery.

[25]  A. Lim,et al.  Use of an arterialized venous flap for resurfacing a circumferential soft tissue defect of a digit , 2001, Microsurgery.

[26]  I. Yannas Studies on the biological activity of the dermal regeneration template , 1998, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[27]  Yoshimitsu Kuroyanagi,et al.  Design of artificial skin , 1996 .

[28]  L. Gottlieb,et al.  From the reconstructive ladder to the reconstructive elevator. , 1994, Plastic and reconstructive surgery.

[29]  D. Heimbach,et al.  Artificial Dermis for Major Burns: A Multi‐Center Randomized Clinical Trial , 1988, Annals of surgery.

[30]  I. Yannas,et al.  Wound tissue can utilize a polymeric template to synthesize a functional extension of skin. , 1982, Science.

[31]  I. Yannas,et al.  Design of an artificial skin. I. Basic design principles. , 1980, Journal of biomedical materials research.