Early wound healing of the hard-palate mucosal harvest site using artificial dermis fixation by a transparent plate

Background There are currently no guidelines for the postoperative wound management of the hard-palate donor site in cases involving mucosal harvesting. This study describes our experiences with the use of an artificial dermis for early epithelialization and transparent plate fixation in cases involving hard-palate mucosal harvesting.<br/>Methods A transparent palatal plate was custom-fabricated using a thermoplastic resin board. After mucosal harvesting, an alginic acid-containing wound dressing (Sorbsan) was applied to the donor site, which was then covered with the plate. After confirming hemostasis, the dressing was changed to artificial dermis a few days later, and the plate was fixed to the artificial dermis. The size of the mucosal defect ranged from 8×25 to 20×40 mm.<br/>Results Plate fixation was adequate, with no postoperative slippage or infection of the artificial dermis. There was no pain at the harvest site, but a slight sense of incongruity during eating was reported. Although the fabrication and application of the palatal plate required extra steps before and after harvesting, the combination of the artificial dermis and palatal plate was found to be very useful for protecting the mucosal harvest site, and resulted in decreased pain and earlier epithelialization.<br/>Conclusions The combination of artificial dermis and a transparent palatal plate for wound management at the hard-palate mucosal donor site resolved some of the limitations of conventional methods.

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A Narrative Review of the History of Skin Grafting in Burn Care

Medicina ◽

10.3390/medicina57040380 ◽

2021 ◽

Vol 57 (4) ◽

pp. 380

Author(s):

Deepak K. Ozhathil ◽

Michael W. Tay ◽

Steven E. Wolf ◽

Ludwik K. Branski

Keyword(s):

Donor Site ◽

Subsequent Development ◽

Skin Grafting ◽

Human Condition ◽

Surgical Instruments ◽

Wound Management ◽

Burn Wound ◽

Medical Progress ◽

Burn Care ◽

History Of

Thermal injuries have been a phenomenon intertwined with the human condition since the dawn of our species. Autologous skin translocation, also known as skin grafting, has played an important role in burn wound management and has a rich history of its own. In fact, some of the oldest known medical texts describe ancient methods of skin translocation. In this article, we examine how skin grafting has evolved from its origins of necessity in the ancient world to the well-calibrated tool utilized in modern medicine. The popularity of skin grafting has ebbed and flowed multiple times throughout history, often suppressed for cultural, religious, pseudo-scientific, or anecdotal reasons. It was not until the 1800s, that skin grafting was widely accepted as a safe and effective treatment for wound management, and shortly thereafter for burn injuries. In the nineteenth and twentieth centuries skin grafting advanced considerably, accelerated by exponential medical progress and the occurrence of man-made disasters and global warfare. The introduction of surgical instruments specifically designed for skin grafting gave surgeons more control over the depth and consistency of harvested tissues, vastly improving outcomes. The invention of powered surgical instruments, such as the electric dermatome, reduced technical barriers for many surgeons, allowing the practice of skin grafting to be extended ubiquitously from a small group of technically gifted reconstructive surgeons to nearly all interested sub-specialists. The subsequent development of biologic and synthetic skin substitutes have been spurred onward by the clinical challenges unique to burn care: recurrent graft failure, microbial wound colonization, and limited donor site availability. These improvements have laid the framework for more advanced forms of tissue engineering including micrografts, cultured skin grafts, aerosolized skin cell application, and stem-cell impregnated dermal matrices. In this article, we will explore the convoluted journey that modern skin grafting has taken and potential future directions the procedure may yet go.

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Cografts of artificial dermis matrix and autogenetic split-thickness of repaired skin in severe hand wounds in patients with deep burns

Archives of Biological Sciences ◽

10.2298/abs1401175l ◽

2014 ◽

Vol 66 (1) ◽

pp. 173-178

Author(s):

Hongqi Liu ◽

Yan Li ◽

Deqian Sha

Keyword(s):

Wound Healing ◽

Hand Function ◽

Donor Site ◽

Test Group ◽

Healing Time ◽

Whole Body ◽

Control Group ◽

Large Area ◽

Artificial Dermis ◽

Thickness Skin

The aim of this paper was to evaluate the effect of using artificial dermis matrix plus autologous split-thickness skin (ADM and ASTS) in the treatment of deep-burns in hands of severely burned patients?We recruited a total of 58 patients with large area burns greater than 80% that were eschar-excised. Twenty-eight of them were treated with ADM and ASTS (test group); 30 were treated with autologous medium-thickness skin (AMTS) (control group). The healing time of the hand wound was noted, clinical and photographic evaluations were performed, and a Jebsen-Taylor hand function test was compared and analyzed in the two groups. The wound healing time in the test group (24.22?3.34 days) were longer than that of the control group (13.42?3.36 days) and statistically significant. The healing time of skin graft donor sites was shorter than that of the control group (7.14?1.63 vs. 14.28?2.37 days) and statistically significant (P<0.05). The 3rd and 6th month follow-up with clinical and functional evaluations revealed no differences between the two groups. In addition, there was no obvious scar formation and less pigmentation in either group. The repair of deeply burned hands with artificial dermis matrix was beneficial to both wound healing and the donor site, and was beneficial to the whole body rehabilitation of severely burned patients.

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Analysis of donor site complications at the anterior iliac crest harvest site for treatment of tibial plateau fractures

International Journal of Orthopaedics Traumatology & Surgical Sciences ◽

10.47618/ijotss/v5i2.10 ◽

2019 ◽

Vol 5 (2) ◽

pp. 257-261

Author(s):

Ashwini Sharma

Keyword(s):

Tibial Plateau ◽

Iliac Crest ◽

Donor Site ◽

Tibial Plateau Fractures ◽

Harvest Site

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The use of integra artificial dermis to minimize donor-site morbidity after suprafascial dissection of the radial forearm flap

Microsurgery ◽

10.1002/micr.20406 ◽

2007 ◽

Vol 27 (7) ◽

pp. 583-587 ◽

Cited By ~ 25

Author(s):

Andreas I. Gravvanis ◽

Dimosthenis A. Tsoutsos ◽

Thomais Iconomou ◽

George Gremoutis

Keyword(s):

Donor Site ◽

Donor Site Morbidity ◽

Radial Forearm Flap ◽

Forearm Flap ◽

Artificial Dermis ◽

Radial Forearm

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Plastic chronic wound management with Cellutome

Phlebologie ◽

10.12687/phleb2303-2-2016 ◽

2016 ◽

Vol 45 (02) ◽

pp. 100-105

Author(s):

G. U. Seip

Keyword(s):

Health Care Providers ◽

Chronic Wounds ◽

Donor Site ◽

Skin Grafting ◽

Minimal Invasive ◽

Wound Management ◽

Wound Treatment ◽

Care Providers ◽

Patients With Diabetes ◽

Chronic Wound Management

SummaryChronic wounds continue to present a significant challenge to health-care providers around the globe. Unlike acute wounds, chronic wounds do not proceed through an orderly process of repair. In recent years many new modalities of modern wound treatment systems have been promoted. However, until recently there were few modalities designed to promote epithelialisation of a fully granulated wound. Mesh graft procedures have long been the gold standard for the management of acute wounds and chronic wounds but have also many disadvantages like discomfort associated with the donor site and the creation of a second painful wound (donor site).The increase of chronical wounds in Germany due to the average age of patients, the aggressiveness of medical treatment and increase of numbers of patients with diabetes and severe polymorbidity requires specialized wound treatment and plastic surgery. Since 2014 there was a new innovative system introduced in the market called Cellutome epidermal harvesting system. The Cellutome system is a epidermal harvesting system for skin grafting and can replace in many cases the traditional meshgraft procedure with a classic dermatoma. The skin donor section on the patient`s thigh heals within days without scarring. The system offers a precise, simplified and minimal invasive option for skin grafting in the treatment of especially chronic wounds.

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Coordination of Tongue Pressure and Jaw Movement in Mastication

Journal of Dental Research ◽

10.1177/154405910608500214 ◽

2006 ◽

Vol 85 (2) ◽

pp. 187-191 ◽

Cited By ~ 76

Author(s):

K. Hori ◽

T. Ono ◽

T. Nokubi

Keyword(s):

Late Stage ◽

Healthy Subjects ◽

Hard Palate ◽

Early Stage ◽

Pressure Sensors ◽

Tongue Pressure ◽

Normal Pattern ◽

Jaw Movements ◽

Jaw Movement ◽

Palatal Plate

The tongue plays an important role in mastication and swallowing by its contact with the hard palate. Using an experimental palatal plate with 7 pressure sensors, and recording jaw movement using mandibular kinesiography, we assessed, in healthy subjects, the coordination of tongue and jaw movements during the entire masticatory sequence of solids, by measuring tongue pressure against the hard palate. Tongue pressure appeared during the occlusal phase, reached a peak near the start of opening, and disappeared during opening. Specific patterns in order, duration, and magnitude of tongue pressure were seen at the 7 pressure sensors in each chewing stroke. Magnitude and duration were significantly larger in the late stage of chewing (8 strokes before initial swallowing) than in the early stage (until 8 strokes after starting mastication). The normal pattern of tongue contact against the hard palate, control of tongue activity, and coordination with jaw movement during mastication is described.

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The use of Integra artificial dermis to minimize donor-site morbidity after suprafascial or subfascial dissection of the radial forearm flap

Microsurgery ◽

10.1002/micr.20912 ◽

2011 ◽

Vol 31 (6) ◽

pp. 502-504 ◽

Cited By ~ 9

Author(s):

Gravvanis Andreas ◽

Lagogiannis George ◽

Delikonstantinou Iraklis ◽

Trigkatzis Platon ◽

Katsikeris Nick ◽

...

Keyword(s):

Donor Site ◽

Donor Site Morbidity ◽

Radial Forearm Flap ◽

Forearm Flap ◽

Artificial Dermis ◽

Radial Forearm

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Regional Grafts for Closure of Postsurgical Defect in Anterior Maxilla: Versatility of Chin Graft and Local Rotational Flap

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1136 ◽

2013 ◽

Vol 4 (1) ◽

pp. 47-50

Author(s):

Varsha Sunil Manekar

Keyword(s):

Donor Site ◽

Surgical Flaps ◽

Donor Site Morbidity ◽

No Donor ◽

Anterior Maxilla ◽

Mucosal Defect ◽

Rotational Flap ◽

Osseous Defect ◽

The Right ◽

Autogenous Grafts

ABSTRACT The management of postsurgical defect is a challenge for the maxillofacial surgeon. With the success of various autogenous grafts and surgical flaps the reconstruction surgery creates definitive results. This article is a case report of reconstruction of osseous defect and closure of soft tissue fenestration in the right anterior maxilla. An autogenous corticocancellous graft from the mandibular symphysis is used for reconstruction of the osseous defect of around 15 × 15 mm. The mucosal fenestration of around 10 × 10 mm is closed by rotational flap based in the labial sulcus. The defect and the donor site healed uneventfully. Both osseous and mucosal defect healed with esthetic results. Thus, the regional flaps prove the versatility by convenience of graft taking, no donor site morbidity and biological resemblance of tissues. How to cite this article Manekar VS. Regional Grafts for Closure of Postsurgical Defect in Anterior Maxilla: Versatility of Chin Graft and Local Rotational Flap. Int J Head and Neck Surg 2013;4(1):47-50.

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Management of the Burn Wound

10.2310/ps.2143 ◽

2019 ◽

Author(s):

Nicole S. Gibran ◽

Jose P. Sterling ◽

David M. Heimbach

Keyword(s):

Wound Care ◽

Donor Site ◽

Skin Grafting ◽

Wound Management ◽

Skin Substitutes ◽

Burn Wound ◽

Burn Wounds ◽

Initial Care ◽

Wound Excision ◽

Burn Depth

Current approaches to burn management are based on an understanding of the biology and physiology of human skin and the pathophysiology of the burn wound. The clinical evaluation and initial care of a burn wound is described and includes an assessment of burn depth, determining the need for escharatomy and daily burn wound care. Burns can be topical or surgical. Topical burn wounds require choice in the use of antibiotics. Considerations and techniques for surgical burn wound management are described and include early excision and grafting, wound excision, skin grafting, graft and donor-site dressings, postoperative wound care, biologic dressings and skin substitutes, allograft and xenograft skin, cultured epidermal autografts, and skin substitutes. Figures show the two distinct layers of the skin, various types of burns, and both fascial and tangential excision of burn wounds. This review contains 12 figures, 11 tables, and 61 references. Keywords: Burn wound, graft, partial-thickness, full-thickness, dermis, epidermis, sloughing, dressing

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