Keywords
Post-traumatic wounds
Skin grafting
How to Cite
Abstract
Background Treatment of patients with post-traumatic severe and chronic wounds poses many challenges. A large number of dermal analogs have been invented in an effort to overcome these challenges. Matriderm, a biosynthetic dermal analog, is made from bovine collagen and elastin. The aim of our study was to prove the effectiveness of MatriDerm® combined with skin grafting versus skin grafting alone in these difficult-to-heal wounds.
Material and Methods: Twenty-two patients with post-traumatic defects with bone exposure and chronic wounds treated in the Clinic of Plastic Reconstructive and Aesthetic Surgery of the University Hospital “St. George” were included in this prospective study. The mean age of the patients was 58 years. The patients were divided into two groups: the experimental and the control group. The patients in the experimental group received a Matriderm appliance and a split-thickness skin graft, while those in the control group received only a split-thickness skin graft. All patients gave their informed consent to participate in the study.
Results: The hospitalization period in the experimental group was 3 weeks and 5 days and in the control group 8 weeks. The period of complete healing was shorter in the experimental group patients (5 weeks) compared with control group patients (9 weeks) with a difference reaching statistical significance (P<0.05). Matriderm enables effective healing and improves elasticity in the treatment of patients with post-traumatic severe and chronic wounds.
Conclusions: With our study, we confirm the evidence of the clinical use of MatriDerm® technology in the healing of soft tissue wounds and prove the effectiveness of combining MatriDerm® and skin grafting for the first time. Moreover, we observed a reduction in wound contraction and an improvement in elasticity, quality of scar tissue, and dermal architecture.
References
Chung CH, Kim DJ, Kim J, et al. Current status of diabetic foot in Korean patients using national health insurance database. J Korean Diabetes Assoc 2006; 30:372-6.
Greenhalgh DG. Wound healing and diabetes mellitus. Clin Plast Surg 2003; 30:37-45.
Kim SH, Kim JW, Kim JB, et al. Multifactorial factors of diabetic foot on diabetes mellitus comparative clinical study. J Korean Soc Plast Reconstr Surg 2002; 29:83-90.
Hanft JR, Surprenant MS. Healing of chronic foot ulcers in diabetic patients treated with a human fibroblast-derived dermis. J Foot Ankle Surg 2002; 41:291-9.
Wetzig T, Gebhardt C, Simon JC. New indications for artificial collagen-elastin matrices? Covering exposed tendons. Dermatology 2009; 219:272-3.
Wagner FW Jr. The diabetic foot. Orthopedics 1987; 10:16372.
Lavery LA, Armstrong DG, Murdoch DP, et al. Validation of the Infectious Diseases Society of America’s diabetic foot infection classification system. Clin Infect Dis 2007; 44:5625.
Eum SJ, Han SK, Gu JH, et al. Treatment of diabetic ulcer using autologous fibroblast-hyaluronic acid complex. J Korean Soc Plast Reconstr Surg 2009;36:548-54.
Yannas IV, Burke JF. Design of an artificial skin I. Basic design principles. J Biomed Mater Res 1980; 14:65–81.
Van Zuijlen PP, van Trier AJ, Vloemans JF, Groenevelt F, Kreis RW, Middelkoop E. Graft survival and effectiveness of dermal substitution in burns and reconstructive surgery in a one stage grafting model. Plast Reconstr Surg 2000; 106:615–23.
Cuono C, Langdon R, McGuire J. Use of cultured epidermal autografts and dermal allografts as skin replacement after burn injury. Lancet 1986; 1:1123-4.
Hamuy R, Kinoshita N, Yoshimoto H, et al. One-stage, simultaneous skin grafting with artificial dermis and basic fibroblast growth factor successfully improves elasticity with maturation of scar formation. Wound Repair Regen 2013; 21:141-54.
Han SK, You HJ. Wound coverage using advanced technology in Korea. J Korean Med Assoc 2011; 54:594-603.
Young MJ, Adams JE, Anderson GF, et al. Medial arterial calcification in the feet of diabetic patients and matched non-diabetic control subjects. Diabetologia 1993; 36:61521.
Weiner RD, Hlad LM, McKenna DR. Recurrence of diabetic pedal ulcerations following tendo achilles lengthening. Diabet Foot Ankle 2011; 2:6417.
Eming SA, Yarmush ML, Morgan JR. Enhanced function of cultured epithelium by genetic modification: cell-based synthesis and delivery of growth factors. Biotechnol Bioeng 1996;52: 15–23.
Myers S, Navsaria H, Sanders R, Green C, Leigh I. Transplantation of keratinoctes in the treatment of wounds. Am J Surg 1995; 170:75–83.
Anastasova V., Evstatiev D., Zanzov E. Surgical behavior of patients with post-burn consequences an 8-year study. Евразийский союз ученых, бр. 1/2016, стр.23-29
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.