Cargando…

Single-stage Composite Skin Reconstruction Using a Dermal Regeneration Template

BACKGROUND: Composite reconstruction with a dermal substitute followed by skin graft is sometimes used for reconstructing high-quality skin while preserving donor sites. This often necessitates 2 separate procedures, additional general anesthetic, and longer hospitalization. Concurrent use of dermal...

Descripción completa

Detalles Bibliográficos
Autores principales: Rudnicki, Pamela A., Purt, Boonyapa, True, Daniel, Siordia, Hector, Lohmeier, Steven, Chan, Rodney K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159934/
https://www.ncbi.nlm.nih.gov/pubmed/32309075
http://dx.doi.org/10.1097/GOX.0000000000002622
_version_ 1783522667271290880
author Rudnicki, Pamela A.
Purt, Boonyapa
True, Daniel
Siordia, Hector
Lohmeier, Steven
Chan, Rodney K.
author_facet Rudnicki, Pamela A.
Purt, Boonyapa
True, Daniel
Siordia, Hector
Lohmeier, Steven
Chan, Rodney K.
author_sort Rudnicki, Pamela A.
collection PubMed
description BACKGROUND: Composite reconstruction with a dermal substitute followed by skin graft is sometimes used for reconstructing high-quality skin while preserving donor sites. This often necessitates 2 separate procedures, additional general anesthetic, and longer hospitalization. Concurrent use of dermal substitutes and skin graft in a single stage has been previously reported in small series. Here, we report our experience with single-stage skin reconstruction with Integra and split-thickness skin graft for coverage of wounds post burn eschar excision and post burn scar contracture release. METHODS: This is a retrospective review of consecutive operations from 2013 to 2017 in which single-stage bilayer reconstruction (SSBR) was performed. Data were obtained from electronic medical records and perioperative photographs. RESULTS: In this 5-year period, 13 surgical sites were identified in which SSBR was used in 8 subjects. Average and median graft take was 86.2% and 95%, respectively. Graft take was over 90% in 10 out of 13 cases. One case required regrafting after initial graft failure. CONCLUSIONS: In the appropriate setting, SSBR is a practical technique in covering wounds post burn eschar excision and post burn scar contracture release resulting in reasonable graft take. Use of noncontaminated wound beds is crucial. Although there is risk of regrafting, it is not clear whether this risk is any higher than in split-thickness skin grafting alone. This study was unable to evaluate contribution of dermal substitute to contraction, function, and mobility, nor how hypothesized improvement of skin quality compares to the original thick dermal substitute. We recommend further investigation.
format Online
Article
Text
id pubmed-7159934
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-71599342020-04-17 Single-stage Composite Skin Reconstruction Using a Dermal Regeneration Template Rudnicki, Pamela A. Purt, Boonyapa True, Daniel Siordia, Hector Lohmeier, Steven Chan, Rodney K. Plast Reconstr Surg Glob Open Original Article BACKGROUND: Composite reconstruction with a dermal substitute followed by skin graft is sometimes used for reconstructing high-quality skin while preserving donor sites. This often necessitates 2 separate procedures, additional general anesthetic, and longer hospitalization. Concurrent use of dermal substitutes and skin graft in a single stage has been previously reported in small series. Here, we report our experience with single-stage skin reconstruction with Integra and split-thickness skin graft for coverage of wounds post burn eschar excision and post burn scar contracture release. METHODS: This is a retrospective review of consecutive operations from 2013 to 2017 in which single-stage bilayer reconstruction (SSBR) was performed. Data were obtained from electronic medical records and perioperative photographs. RESULTS: In this 5-year period, 13 surgical sites were identified in which SSBR was used in 8 subjects. Average and median graft take was 86.2% and 95%, respectively. Graft take was over 90% in 10 out of 13 cases. One case required regrafting after initial graft failure. CONCLUSIONS: In the appropriate setting, SSBR is a practical technique in covering wounds post burn eschar excision and post burn scar contracture release resulting in reasonable graft take. Use of noncontaminated wound beds is crucial. Although there is risk of regrafting, it is not clear whether this risk is any higher than in split-thickness skin grafting alone. This study was unable to evaluate contribution of dermal substitute to contraction, function, and mobility, nor how hypothesized improvement of skin quality compares to the original thick dermal substitute. We recommend further investigation. Wolters Kluwer Health 2020-02-24 /pmc/articles/PMC7159934/ /pubmed/32309075 http://dx.doi.org/10.1097/GOX.0000000000002622 Text en Copyright © 2020 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 terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Article
Rudnicki, Pamela A.
Purt, Boonyapa
True, Daniel
Siordia, Hector
Lohmeier, Steven
Chan, Rodney K.
Single-stage Composite Skin Reconstruction Using a Dermal Regeneration Template
title Single-stage Composite Skin Reconstruction Using a Dermal Regeneration Template
title_full Single-stage Composite Skin Reconstruction Using a Dermal Regeneration Template
title_fullStr Single-stage Composite Skin Reconstruction Using a Dermal Regeneration Template
title_full_unstemmed Single-stage Composite Skin Reconstruction Using a Dermal Regeneration Template
title_short Single-stage Composite Skin Reconstruction Using a Dermal Regeneration Template
title_sort single-stage composite skin reconstruction using a dermal regeneration template
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159934/
https://www.ncbi.nlm.nih.gov/pubmed/32309075
http://dx.doi.org/10.1097/GOX.0000000000002622
work_keys_str_mv AT rudnickipamelaa singlestagecompositeskinreconstructionusingadermalregenerationtemplate
AT purtboonyapa singlestagecompositeskinreconstructionusingadermalregenerationtemplate
AT truedaniel singlestagecompositeskinreconstructionusingadermalregenerationtemplate
AT siordiahector singlestagecompositeskinreconstructionusingadermalregenerationtemplate
AT lohmeiersteven singlestagecompositeskinreconstructionusingadermalregenerationtemplate
AT chanrodneyk singlestagecompositeskinreconstructionusingadermalregenerationtemplate