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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2020
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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 |
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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 |
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