scholarly journals Reconstruction for Defects of Total Nail Bed and Germinal Matrix Loss with Acellular Dermal Matrix Coverage and Subsequently Skin Graft

Medicina ◽  
2020 ◽  
Vol 56 (1) ◽  
pp. 17
Author(s):  
Tsung-Hsien Liu ◽  
Meng-Chien Hsieh ◽  
Ping-Ruey Chou ◽  
Shu-Hung Huang
Keyword(s):  
Skin Graft ◽  
Donor Site ◽  
Acellular Dermal Matrix ◽  
Dermal Matrix ◽  
Germinal Matrix ◽  
Nail Bed ◽  
Staged Operation ◽  
Matrix Loss ◽  
Bone Exposure ◽  
Acellular Dermal

Background and Objectives: Nail bed and germinal matrix loss due to wide excision for fingertip tumors or malignancy are occasionally encountered complications. These defects also result from severely comminuted fingertip crush injuries. Large-area dorsal finger or toenail bed defects, which usually present with phalangeal bone exposure, remain challenging regardless of the usage of different reconstruction strategies. This study aimed to evaluate the clinical outcome of a staged operation with an acellular dermal matrix coverage and subsequent skin graft as reconstruction for defects of total nail bed, germinal matrix loss, and bone exposure. Materials and Methods: From April 2018 to October 2019, four patients with total nail bed, germinal matrix, and bone exposure loss after surgery were enrolled in our series. A staged operation of the acellular dermal matrix coverage with subsequent skin graft was performed on these patients. Skin graft take rate, oncological prognosis, and cosmetic outcome were evaluated. Patients were followed up for 5–13 months. An excellent skin graft take rate with a satisfying aesthetic result without local malignancy recurrence was noted. Minimal functional deficit and donor site morbidity were reported. Results: A staged operation with acellular dermal matrix coverage and subsequent skin graft proves to serve as a feasible strategy for patients who experience total nail bed, germinal matrix loss, and bone exposure after surgery. Conclusions: This reconstruction method provides a reliable repair result, satisfying aesthetic outcomes, as well as having minimal functional deficits and donor site morbidity.

Acellular dermal matrix reconstruction of a nail bed avulsion in a 13-year-old child

2020 ◽  
Vol 13 (9) ◽  
pp. e236253
Author(s):  
Ailbhe L Kiely ◽  
Lilli RL Cooper ◽  
Aina Greig
Keyword(s):  
Donor Site ◽  
Acellular Dermal Matrix ◽  
Distal Phalanx ◽  
Dermal Matrix ◽  
No Donor ◽  
Nail Bed ◽  
Matrix Reconstruction ◽  
History Of ◽  
One Step ◽  
Acellular Dermal

Nail bed avulsion injuries often require reconstruction, particularly in cases where the avulsed fragment is lost. We describe a simple way to reconstruct a large nail bed defect, with no donor site. A 13-year-old boy with a hypoplastic left heart and autism accidentally sustained a left little distal phalanx injury with an avulsion of 60% of the nail bed, exposing the distal phalanx. This boy had a history of poor compliance, qualifying the need to find a technique that would minimise operative time and dressing changes. As such, it was elected to use an acellular dermal matrix (ADM) (Matriderm) as a one-step reconstruction. Signs of vascularisation of the ADM were noted at 2 weeks, and 3-month follow-up demonstrated integration, with normal nail growth. We found that Matriderm was able to support the regeneration of a full thickness wound in a simple one-step procedure.

Human Acellular Dermal Matrix is a Viable Alternative to Autologous Skin Graft in Patients with Cutaneous Malignancy

2019 ◽  
Vol 85 (9) ◽  
pp. 1056-1060
Author(s):  
Rachel E. Lewis ◽  
Emily A. Towery ◽  
Sneha G. Bhat ◽  
Andrew J. Ward ◽  
Robert E. Heidel ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Cell Carcinoma ◽  
Donor Site ◽  
Acellular Dermal Matrix ◽  
Healing Time ◽  
Viable Alternative ◽  
Skin Substitutes ◽  
Dermal Matrix ◽  
Acellular Dermal ◽  
Human Acellular Dermal Matrix

Skin substitutes have shown success in complex wound reconstruction. We evaluate the use of a human acellular dermal matrix (ADM) as a viable alternative to autologous skin grafting for defects secondary to skin cancer excision. An institutional review board–approved, retrospective review of ADM-reconstructed defects secondary to skin cancer excision between 2012 and 2018 was conducted. ADM was indicated in patients with preclusive factors for general anesthesia, protracted procedure time, reluctance for additional donor site wound, and personal choice. We reviewed defect characteristics, healing time, postoperative outcomes, and patient demographics. The 228 participants (151 males, 77 females) had a median age of 72 years (range, 29–95 years), with melanoma diagnosed in 113 (49.6%), squamous cell carcinoma in 61 (26.8%), and basal cell carcinoma in 28 (12.2%) patients. The median interval to complete epidermal coverage was 42 days, with graft failure evident in six patients (2.6%). ADM is a viable, low-morbid alternative for reconstruction of defects secondary to skin cancer excision, with no donor site morbidity. With exception to complete healing time, outcomes are similar to those of autologous grafting.

scholarly journals Reconstruction of Traumatic Defect of the Lower Third of the Leg Using a Combined Therapy: Negative Pressure Wound Therapy, Acellular Dermal Matrix, and Skin Graft

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Sergio Brongo ◽  
Domenico Pagliara ◽  
Nicola Campitiello ◽  
Corrado Rubino
Keyword(s):  
Skin Graft ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Combined Therapy ◽  
Operating Time ◽  
Acellular Dermal Matrix ◽  
Special Equipment ◽  
Wound Therapy ◽  
Dermal Matrix ◽  
Acellular Dermal

The reconstruction of lower third of the leg is one of the most challenging problems for plastic and reconstructive surgeons and current approaches are still disappointing. We show an easy option to obtain a coverage of traumatic pretibial defects with good aesthetic and functional results: the association of negative pressure wound therapy, acellular dermal matrix, and skin graft. The choice of this combined therapy avoids other surgical procedures such as local perforator flaps and free flaps that require more operating time, special equipment, and adequate training.

scholarly journals Acellular dermal matrix treats lower extremity full-thickness skin defect on one-stage without skin graft or flaps

2020 ◽  
Author(s):  
Gongchi Li ◽  
Pan Zhou ◽  
Hanlin Liu ◽  
Han Peng ◽  
Binghui Li ◽  
...  
Keyword(s):  
Wound Healing ◽  
Lower Extremity ◽  
Skin Graft ◽  
Lower Extremities ◽  
Acellular Dermal Matrix ◽  
Matrix Product ◽  
Skin Defect ◽  
Full Thickness ◽  
Dermal Matrix ◽  
Acellular Dermal

Abstract Background Self-repair of lower limb wounds has always been one of the research hotspots. Flaps and skin graft are the preferred treatment for lower extremity wound reconstruction. However, these treatments have many disadvantages, such as secondary damage, poor healing quality. In recent years, the use of acellular dermal matrix has emerged as an alternative treatment option for extremity ulcers. Methods This study aimed to explore whether acellular dermal matrix can be used as a single treatment to promote wound healing. 7 patients with lower extremities cutaneous deficiency exposing bone or tendon, was covered by Pelnac, which was an acellular dermal matrix product approved by China Food and Drug Administration. All the wound was treated by Pelnac without flaps and skin graft. The external dressing was changed every 10 days. Results After a maximum of 20 weeks, all the wounds were completely healed. During the 12 months follow-up period none of the patients developed skin wear on the treatment area. All patients maintained their postoperative ambulatory ability. All patients were satisfied with the appearance and feeling after wound healing. Conclusions These findings may mean acellular dermal matrix is a novel method offering opportunity for treatment of lower extremities cutaneous deficiency exposing bone or tendon. It also has the potential to close wounds of all uninfected, non-ischemic, full-thickness cutaneous deficiency.

scholarly journals Outcome of the acellular dermal matrix and split thickness skin graft in release of post burn contractures in hand.

2021 ◽  
Vol 28 (02) ◽  
pp. 147-152
Author(s):  
Abdul Malik Mujahid ◽  
Husnain Khan ◽  
Yawer Sajjad ◽  
Kashif Mehmood Sheikh ◽  
Noor Ali ◽  
...  
Keyword(s):  
Skin Graft ◽  
Reconstructive Surgery ◽  
Case Series ◽  
Acellular Dermal Matrix ◽  
Split Thickness Skin Graft ◽  
Dermal Matrix ◽  
Thickness Skin ◽  
Acellular Dermal ◽  
Surgery Center ◽  
Burn Contractures

Objective: To determine the frequency of success of acellular dermal matrix and split thickness skin graft in release of post burn contractures in hand using Vancouver scar scale. Study Design: Descriptive Case Series. Setting: Department of Plastic Surgery, Jinnah Burn and Reconstructive Surgery Center, Lahore. Period: 1st March, 2019 to 30th October, 2019. Material & Method: A descriptive case series conducted at Plastic Surgery Department, Jinnah Burn and Reconstructive Surgery Center, Lahore. A sample size of 75 patients, who full filled the inclusion criteria, was selected through non probability consecutive sampling Informed consent was obtained from all the patients. Pre-operative photography was done to compare the post-operative results. After the release of contractures, coverage with acellular dermis and split thickness skin graft was performed. All the patients were followed up to 2 months and the outcome was assessed by Vancouver Scar Scale. The collected data was entered and analyzed by using SPSS version 20. Descriptive statistics were calculated. Quantitative variables like age, size of scar were presented as mean, ± standard deviation. Qualitative variables were presented as frequencies and percentages. Results: Mean age of patient was 30 ± 9 years. Among them 40 were males and 35 females. Vancouver scale showed successful outcome (score ≤4) in 70.66 % of the patients. Partial release of contracture was the major complication seen in 5.33% of cases. Conclusion: Acelluar dermal matrix followed by split thickness skin graft is a very reliable option for coverage after release of post-burn contractures in hand as it provides very pliable, thin and lax skin with good color match and better contour to surrounding tissue.

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