Use of cadaveric skin allograft and Integra Dermal Regeneration Template to manage deep lower limb injuries.

IF 1.5 4区医学 Q3 DERMATOLOGY Journal of wound care Pub Date : 2025-03-02 DOI:10.12968/jowc.2023.0230

Gustavo E Prezzavento, Lucila M Olivera Whyte, Rodrigo N Juárez Calvi, Juan A Rodríguez, Philippe Taupin

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Abstract

Objective: In full-thickness wounds, it is necessary to have an appropriate dermal replacement because dermal tissue does not regenerate into normal dermis after injury. The use of a dermal matrix underneath a skin graft during the healing process provides a scaffold that supports tissue growth, resulting in improvement of cosmesis and functional outcomes. The management of large wounds with deep skin impairment using a combination of dermal matrices has not been exhaustively studied. The objective of this study was to evaluate the results of managing lower limb trauma, with deep skin impairment, by combining the use of dermal matrices in stages.

Method: This was a retrospective study of patients with lower limb trauma managed using a combination of cadaveric skin and Integra Dermal Regeneration Template (IDRT; Integra LifeSciences Corp., US) in stages, followed by an autologous skin graft, in the Hospital Aleman, Buenos Aires, Argentina from 2014-2021. Cosmesis was evaluated with the Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS). Functional outcomes were assessed one year after surgery.

Results: In total, five patients were treated. The average affected body surface area was 11.2%. The average cadaveric skin, IDRT and skin autograft take rates were 98.4%, 98.4% and 99%, respectively. Upon follow-up, six months after surgery, the mean VSS was 3.2 and the mean POSAS was 27.8. After 12 months, the mean VSS was 2.6 and the mean POSAS was 22.6. In addition, no depression of the covered surfaces was observed. All patients recovered full articular function and movement after physical therapy.

Conclusion: All patients presented full wound coverage with satisfactory cosmesis and functional outcomes. The combination of the use of cadaveric skin and IDRT consecutively in the same wound bed provides promising results for the management of lower limb trauma wounds with deep skin impairment.

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来源期刊

Journal of wound care DERMATOLOGY-

CiteScore

2.90

自引率

10.50%

发文量

215

期刊介绍： Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.