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Retrospective analysis of 56 soft tissue defects treated with one‐stage reconstruction using dermal skin substitutes
Author(s) -
Gümbel Denis,
Ackerl Martin,
Napp Matthias,
Daeschlein Georg,
Spranger Nikolai,
Stope Matthias B.,
Ekkernkamp Axel,
Matthes Gerrit
Publication year - 2016
Publication title -
jddg: journal der deutschen dermatologischen gesellschaft
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 60
eISSN - 1610-0387
pISSN - 1610-0379
DOI - 10.1111/ddg.12874
Subject(s) - medicine , surgery , skin grafting , soft tissue , plastic surgery , amputation , complication , wound closure , wound healing
Summary Background The closure of wounds associated with soft tissue defects is surgically challenging, frequently requiring extensive plastic surgery and free flaps. The combination of dermal skin substitutes and split‐thickness skin grafting is an innovative method used to cover such wounds. We incorporated this technique into the standard therapeutic armamentarium for complex injuries to the extremities. Clinical results of 56 patients thus treated are presented. Patients and methods In 44 (78.6 %) cases, the method described was used for defects on the lower extremities, including seven (12.5 %) individuals undergoing amputation stump coverage. Twelve (21.4 %) defects were located on the upper extremities. In two (3.6 %) cases, Matriderm ® matrix was used to protect nerves from adjacent surgical implants. Results In 41 (73.2 %) patients, the graft healed without any complication. Fifteen (26.8 %) patients displayed impaired wound healing following defect closure and were subsequently managed conservatively. One patient (1.8 %) showed graft failure, leading to revision surgery. None of the patients required extensive plastic surgery. Conclusions In cases where plastic surgery is unavailable or undesirable, the use of dermal skin substitutes in combination with split‐thickness skin grafting represents a promising alternative for covering wounds associated with soft tissue defects.