Permanent use of acellular dermal matrix for complicated wounds in plastic surgery

Afshin Fathi,1,*

Abstract


Introduction

Acellular dermal matrix (adm) is most commonly used in poorly vascularized wounds to improve the condition of the wound before wound coverage. as a result, the wound closure using adm is the appropriate substitute for using synthetic dressing or biomaterials or microscopic tissue transplantation. the aim of this study was to evaluate the results of use of adm and autologous skin graft for wound closure in the patients.

Methods

a prospective analysis was performed on the use of adm in the preparation of complicated wounds for wound closure. twelve patients with chronic ulcers caused by malignant skin tumors were included in this study. all patients were selected from october 2017 to september 2018 in our plastic surgery department. none of the patients had the possibility of repairing the wound with an autologous skin graft alone. the number of 38 pieces of adm produced at the center of tissue research and transplantation at tehran university of medical sciences were used. at first, the wound was debridement and after the preparation of adm in the normal saline at a concentration of 0.9%, it was placed on the wound by an autologous skin graft over it.

Results

Adm was used as a biological cover in 7 patients and as primary coverage in 3 patients. after three months, the color of the composite skin in 7 patients was similar to the color of to the normal skin, good elasticity; no composite skin graft contracture or scars were observed and very high patients satisfaction.

Conclusion

Adm can be used as a biological dressing for complex wounds that cannot be closed at any time. it seems that in addition to better preparation of the wound before autograft, prevents difficult microscopic surgery or costly dressings.

Keywords

Acellular dermal matrix , chronic ulcers , malignant skin tumors