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Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss
Restoring function after traumatic defects of the palm is a reconstructive challenge, considering the need for flexible, elastic, and resistant skin. Dermal skin substitutes are biologically engineered materials composed of collagen and glycosaminoglycan, devoid of cellular structures. These biodegr...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908327/ https://www.ncbi.nlm.nih.gov/pubmed/31942319 http://dx.doi.org/10.1097/GOX.0000000000002551 |
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author | Lucas, Dominique Di Rocco, Damien Müller, Camillo T. Jurjus, Abdo R. Raffoul, Wassim di Summa, Pietro G. Watfa, William |
author_facet | Lucas, Dominique Di Rocco, Damien Müller, Camillo T. Jurjus, Abdo R. Raffoul, Wassim di Summa, Pietro G. Watfa, William |
author_sort | Lucas, Dominique |
collection | PubMed |
description | Restoring function after traumatic defects of the palm is a reconstructive challenge, considering the need for flexible, elastic, and resistant skin. Dermal skin substitutes are biologically engineered materials composed of collagen and glycosaminoglycan, devoid of cellular structures. These biodegradable materials act as artificial dermis and stimulate neovascularization: they have been used for many years, mainly on the dorsal side of the hand and fingers, whereas the palmar side of the hand has been generally addressed by local flaps. In this study, we described our experience with dermal skin substitutes in two cases of palmar defects associated with exposed tendinous structures. Coverage of palmar defects in hand and fingers with dermal substitute and split thickness skin graft was performed on two patients. Both patients presented palmar-only loss of tissue (traumatic palmar amputation in the first patient and degloving-type injury in the second patient). Range of motion, functional outcomes, and satisfaction and aesthetical results were evaluated. The resulting skin showed good quality, thickness, pliability, and Disabilities of the Arm, Shoulder, and Hand (DASH) score. Additionally, the patients regained full range of motion and reported high satisfaction. The association of split thickness skin graft with dermal substitutes in palmar traumatic hand showed optimal functional and aesthetic outcomes. Although being more adapted to dorsal loss of substance, collagen-based dermal substitutes can also be useful reconstructive tools in palmar defects with exposed structures and could be used to a larger extent in the future. |
format | Online Article Text |
id | pubmed-6908327 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-69083272020-01-15 Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss Lucas, Dominique Di Rocco, Damien Müller, Camillo T. Jurjus, Abdo R. Raffoul, Wassim di Summa, Pietro G. Watfa, William Plast Reconstr Surg Glob Open Ideas and Innovation Restoring function after traumatic defects of the palm is a reconstructive challenge, considering the need for flexible, elastic, and resistant skin. Dermal skin substitutes are biologically engineered materials composed of collagen and glycosaminoglycan, devoid of cellular structures. These biodegradable materials act as artificial dermis and stimulate neovascularization: they have been used for many years, mainly on the dorsal side of the hand and fingers, whereas the palmar side of the hand has been generally addressed by local flaps. In this study, we described our experience with dermal skin substitutes in two cases of palmar defects associated with exposed tendinous structures. Coverage of palmar defects in hand and fingers with dermal substitute and split thickness skin graft was performed on two patients. Both patients presented palmar-only loss of tissue (traumatic palmar amputation in the first patient and degloving-type injury in the second patient). Range of motion, functional outcomes, and satisfaction and aesthetical results were evaluated. The resulting skin showed good quality, thickness, pliability, and Disabilities of the Arm, Shoulder, and Hand (DASH) score. Additionally, the patients regained full range of motion and reported high satisfaction. The association of split thickness skin graft with dermal substitutes in palmar traumatic hand showed optimal functional and aesthetic outcomes. Although being more adapted to dorsal loss of substance, collagen-based dermal substitutes can also be useful reconstructive tools in palmar defects with exposed structures and could be used to a larger extent in the future. Wolters Kluwer Health 2019-11-27 /pmc/articles/PMC6908327/ /pubmed/31942319 http://dx.doi.org/10.1097/GOX.0000000000002551 Text en Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Ideas and Innovation Lucas, Dominique Di Rocco, Damien Müller, Camillo T. Jurjus, Abdo R. Raffoul, Wassim di Summa, Pietro G. Watfa, William Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss |
title | Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss |
title_full | Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss |
title_fullStr | Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss |
title_full_unstemmed | Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss |
title_short | Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss |
title_sort | application of dermal skin substitutes for hand and finger palmar soft tissue loss |
topic | Ideas and Innovation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908327/ https://www.ncbi.nlm.nih.gov/pubmed/31942319 http://dx.doi.org/10.1097/GOX.0000000000002551 |
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