Dermal Regeneration Matrix in the Treatment of Acute Complex Wounds

Daniel Francisco Mello, PhD

Disclosures

Wounds. 2022;34(6):154-158. 

In This Article

Results

Twenty patients (6 female, 14 male) with an average age of 47.3 years (range, 20–74 years) were treated (Table). Trauma was the most frequent etiology, occurring in 8 patients (4 full-thickness burns, 4 degloving injuries). Seven patients presented with complications related to surgical procedures (ie, surgical site occurrence), and there was 1 instance of infection (fasciitis). Two patients presented with open wounds after treatment of infection resulting from diabetic foot syndrome, and 2 were treated for skin necrosis caused by hypertonic solutions extravasation injuries of the upper limbs.

The measurement of the treated wounds varied between 4 cm × 5 cm to 42 cm × 28 cm, in the greatest dimensions. Negative pressure wound therapy was used for all patients in the wound preparation phase. It was also used after DRM implantation (when 2-mm thickness was used) and after STSG.

In 6 cases, DRM that was 1-mm thick was used, and STSG was performed in the same procedure. Visual observation indicated almost 100% integration assessed on postoperative day 5. In 14 cases, DRM that was 2-mm thick was used, and STSG was performed 7 to 9 days later. In all cases, almost 100% integration of the implant was achieved. Patients received a thin STSG, with integration rates close to 100%, assessed on postoperative day 5. Wound healing progression is illustrated in Figure 1 and Figure 2.

Figure 1.

Case 3: A 36-year-old male sustained injuries after being run over by a truck. (A) Gluteal wound after 15 days of negative pressure wound therapy. (B) Total integration of 2-mm–thick dermal regenerative matrices 7 days after implantation; split-thickness skin grafting (STSG) was done at this time. (C) Total integration occurred 7 days after STSG. (D) Appearance 12 months postoperatively.

Figure 2.

Case 2: A 29-year-old male presented with necrotizing fasciitis. (A) Right arm circumferential wound after implantation of the 2-mm–thick dermal regeneration matrix. (B) Fifteen days after split-thickness skin grafting. (C) Pinch test 12 months postoperatively.

No complications (eg, infection, loss of DRM implants or STSG, inflammatory or allergic reactions) occurred in either treatment group. The VSS scores at 12-month follow-up ranged from zero to 6 (average, 2.25 ± 0.65).

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