The Use of Matriderm and Autologous Skin Graft in the Treatment of Full Thickness Skin Defects

 

 Lizenzen und Reprints

Background For patients with full thickness skin defects, autologous Split-thickness skin grafts (STSG) are generally regarded as the mainstay of treatment. However, skin grafts have some limitations, including undesirable outcomes resulting from scars, poor elasticity, and limitations in joint movement due to contractures. In this study, we present outcomes of Matriderm grafts used for various skin tissue defects whether it improves on these drawbacks.

Methods From January 2010 to March 2012, a retrospective review of patients who had undergone autologous STSG with Matriderm was performed. We assessed graft survival to evaluate the effectiveness of Matriderm. We also evaluated skin quality using a Cutometer, Corneometer, Tewameter, or Mexameter, approximately 12 months after surgery.

Results A total of 31 patients underwent STSG with Matriderm during the study period. The success rate of skin grafting was 96.7%. The elasticity value of the portion on which Matriderm was applied was 0.765 (range, 0.635-0.800), the value of the trans-epidermal water loss (TEWL) was 10.0 (range, 8.15-11.00) g/hr/m², and the humidification value was 24.0 (range, 15.5-30.0). The levels of erythema and melanin were 352.0 arbitrary unit (AU) (range, 299.25-402.75 AU) and 211.0 AU (range, 158.25-297.00 AU), respectively. When comparing the values of elasticity and TEWL of the skin treated with Matriderm to the values of the surrounding skin, there was no statistically significant difference between the groups.

Conclusions The results of this study demonstrate that a dermal substitute (Matriderm) with STSG was adopted stably and with minimal complications. Furthermore, comparing Matriderm grafted skin to normal skin using Cutometer, Matriderm proved valuable in restoring skin elasticity and the skin barrier.

Publikationsverlauf

Eingereicht: 22. Januar 2014

Angenommen: 27. Februar 2014

Artikel online veröffentlicht:
05. Mai 2022

© 2014. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

• References

• 1 Cervelli V, Brinci L, Spallone D. et al. The use of MatriDerm (R) and skin grafting in post-traumatic wounds. Int Wound J 2011; 8: 400-405
  CrossrefPubMedGoogle Scholar
• 2 Yannas IV, Burke JF, Gordon PL. et al. Design of an artificial skin II Control of chemical composition. J Biomed Mater Res 1980; 14: 107-132
  CrossrefPubMedGoogle Scholar
• 3 Juhasz I, Kiss B, Lukacs L. et al. Long-term followup of dermal substitution with acellular dermal implant in burns and postburn scar corrections. Dermatol Res Pract 2010; 2010: 210150
  PubMedGoogle Scholar
• 4 Eming SA, Yarmush ML, Morgan JR. Enhanced function of cultured epithelium by genetic modification: Cell-based synthesis and delivery of growth factors. Biotechnol Bioeng 1996; 52: 15-23
  CrossrefPubMedGoogle Scholar
• 5 Myers S, Navsaria H, Sanders R. et al. Transplantation of keratinocytes in the treatment of wounds. Am J Surg 1995; 170: 75-83
  CrossrefPubMedGoogle Scholar
• 6 Philandrianos C, Andrac-Meyer L, Mordon S. et al. Comparison of five dermal substitutes in full-thickness skin wound healing in a porcine model. Burns 2012; 38: 820-829
  CrossrefPubMedGoogle Scholar
• 7 Burke JF, Yannas IV, Quinby Jr WC. et al. Successful use of a physiologically acceptable artificial skin in the treatment of extensive burn injury. Ann Surg 1981; 194: 413-428
  CrossrefPubMedGoogle Scholar
• 8 van Zuijlen PP, van Trier AJ, Vloemans JF. et al. Graft survival and effectiveness of dermal substitution in burns and reconstructive surgery in a one-stage grafting model. Plast Reconstr Surg 2000; 106: 615-623
  CrossrefPubMedGoogle Scholar
• 9 Sinha UK, Shih C, Chang K. et al. Use of AlloDerm for coverage of radial forearm free flap donor site. Laryngoscope 2002; 112: 230-234
  CrossrefPubMedGoogle Scholar
• 10 Wainwright DJ. Use of an acellular allograft dermal matrix (AlloDerm) in the management of full-thickness burns. Burns 1995; 21: 243-248
  CrossrefPubMedGoogle Scholar
• 11 Yim H, Cho YS, Seo CH. et al. The use of AlloDerm on major burn patients: AlloDerm prevents post-burn joint contracture. Burns 2010; 36: 322-328
  CrossrefPubMedGoogle Scholar
• 12 Haslik W, Kamolz LP, Nathschlager G. et al. First experiences with the collagen-elastin matrix Matriderm as a dermal substitute in severe burn injuries of the hand. Burns 2007; 33: 364-368
  CrossrefPubMedGoogle Scholar
• 13 Jones I, Currie L, Martin R. A guide to biological skin substitutes. Br J Plast Surg 2002; 55: 185-193
  CrossrefPubMedGoogle Scholar
• 14 Middelkoop E, de Vries HJ, Ruuls L. et al. Adherence, proliferation and collagen turnover by human fibroblasts seeded into different types of collagen sponges. Cell Tissue Res 1995; 280: 447-453
  CrossrefPubMedGoogle Scholar
• 15 de Vries HJ, Middelkoop E, Mekkes JR. et al. Dermal regeneration in native non-cross-linked collagen sponges with different extracellular matrix molecules. Wound Repair Regen 1994; 2: 37-47
  CrossrefPubMedGoogle Scholar
• 16 De Vries HJ, Mekkes JR, Middelkoop E. et al. Dermal substitutes for full-thickness wounds in a one-stage grafting model. Wound Repair Regen 1993; 1: 244-252
  CrossrefPubMedGoogle Scholar
• 17 Enomoto DN, Mekkes JR, Bossuyt PM. et al. Quantification of cutaneous sclerosis with a skin elasticity meter in patients with generalized scleroderma. J Am Acad Dermatol 1996; 35: 381-387
  CrossrefPubMedGoogle Scholar
• 18 Janzekovic Z. A new concept in the early excision and immediate grafting of burns. J Trauma 1970; 10: 1103-1108
  CrossrefPubMedGoogle Scholar
• 19 De Vries HJ, Zeegelaar JE, Middelkoop E. et al. Reduced wound contraction and scar formation in punch biopsy wounds. Native collagen dermal substitutes. A clinical study. Br J Dermatol 1995; 132: 690-697
  PubMedGoogle Scholar
• 20 Oliveira GV, Chinkes D, Mitchell C. et al. Objective assessment of burn scar vascularity, erythema, pliability, thickness, and planimetry. Dermatol Surg 2005; 31: 48-58
  CrossrefPubMedGoogle Scholar
• 21 van Zuijlen PP, Angeles AP, Kreis RW. et al. Scar assessment tools: implications for current research. Plast Reconstr Surg 2002; 109: 1108-1122
  CrossrefPubMedGoogle Scholar
• 22 Ryssel H, Gazyakan E, Germann G. et al. The use of MatriDerm in early excision and simultaneous autologous skin grafting in burns: a pilot study. Burns 2008; 34: 93-97
  CrossrefPubMedGoogle Scholar
• 23 Hamuy R, Kinoshita N, Yoshimoto H. et al. One-stage, simultaneous skin grafting with artificial dermis and basic fibroblast growth factor successfully improves elasticity with maturation of scar formation. Wound Repair Regen 2013; 21: 141-154
  CrossrefPubMedGoogle Scholar
• 24 Jeon H, Kim J, Yeo H. et al. Treatment of diabetic foot ulcer using matriderm in comparison with a skin graft. Arch Plast Surg 2013; 40: 403-408
  Artikel in Thieme ConnectPubMedGoogle Scholar
• 25 Bloemen MC, van Gerven MS, van der Wal MB. et al. An objective device for measuring surface roughness of skin and scars. J Am Acad Dermatol 2011; 64: 706-715
  CrossrefPubMedGoogle Scholar