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Comparative Skin Evaluation After Split-Thickness Skin Grafts Using 2 Different Acellular Dermal Matrices to Cover Composite Forearm Defects

Authors
 Myung Chul Lee  ;  Yong Jun Jang  ;  In Sik Yun  ;  Dae Hyun Lew  ;  Won Jai Lee 
Citation
 Journal of Hand Surgery, Vol.42(4) : e1-297.e10, 2017 
Journal Title
 Journal of Hand Surgery 
ISSN
 0363-5023 
Issue Date
2017
MeSH
Acellular Dermis* ; Adult ; Aged ; Animals ; Cadaver ; Cattle ; Dermatologic Surgical Procedures ; Female ; Forearm/surgery* ; Forearm Injuries/etiology ; Forearm Injuries/surgery* ; Head and Neck Neoplasms/surgery* ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures/methods ; Retrospective Studies ; Skin ; Skin Transplantation/methods* ; Skin, Artificial ; Surgical Flaps ; Transplantation, Autologous ; Wound Healing ; Wounds and Injuries/etiology ; Wounds and Injuries/surgery*
Keywords
Acellular dermal matrix ; functional skin value ; radial forearm flap donor site
Abstract
PURPOSE: The combination of acellular dermal matrix (ADM) and split-thickness skin graft (STSG) has been widely adopted to overcome functional and cosmetic limitations of conventional STSG. In this study, we evaluated the efficacy of this combination using 2 types of ADM: cadaveric acellular dermal matrix (CDM) and bovine acellular dermal matrix (BDM). METHODS: We recruited 72 patients undergoing autologous STSG to cover radial forearm free flap donor sites. They were included in 1 of 3 therapeutic groups: group 1, STSG using CDM (n = 29); group 2, STSG using BDM (n = 20); and group 3, STSG only (n = 23). Functional skin values for skin elasticity, humidification, transepidermal water loss, and color were determined. Values were compared between graft sites and adjacent normal (control) skin, and between grafted areas of each group. RESULTS: All skin defects were successfully reconstructed without graft loss. Groups 1 and 2 demonstrated better elasticity than did group 3, based on the analysis using the ratio of grafted area to control. Grafted areas in all 3 groups exhibited less moisture than did control normal skin. There was less transepidermal water loss in group 1 than in group 3, which implied that CDM application had better barrier capacity against water evaporation. Graft sites of groups 1 and 3 exhibited darker and redder color compared with control areas. CONCLUSIONS: Composite forearm defects were successfully restored and exhibited acceptable quality after treatment with an ADM plus STSG. Applying either CDM or BDM under a STSG was a suitable procedure, as verified by objective measurements. Elasticity was well preserved in CDM and BDM groups. However, both ADMs revealed functional impairment of humidification. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161075
DOI
10.1016/j.jhsa.2017.01.026
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실)
Yonsei Authors
유대현(Lew, Dae Hyun) ; 윤인식(Yun, In Sik) ; 이원재(Lee, Won Jai) ; 장용준(Jang, Yong Jun)
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Full Text
https://www.sciencedirect.com/science/article/pii/S0363502317301636
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