Introduction: Surgical closure of large soft-tissue wounds presents challenges in surgical technique. Early excision and prompt wound coverage lessens morbidity and improves survival in these patients. Bilaminate bioartificial skin substitute (BBSS, Integra® Dermal Regeneration Template, Integra LifeSciences Corp., Plainsboro, New Jersey) has been described as a temporary substitute prior to autografting in acute burns. Purpose: The purpose of this study was to evaluate the benefit of BBSS for the closure of large non-burn soft-tissue wound defects. Methods: Fifteen patients were evaluated with large soft-tissue defects resulting from traumatic and infectious processes. Wounds were evaluated and managed in a similar fashion including debridement and topical antimicrobials. BBSS was placed and allowed to engraft over a period of 17 to 28 days. Wound closure was accomplished by ultrathin epidermal grafting. Results: Seven patients had traumatic soft-tissue injuries, and eight patients had soft-tissue defects as a consequence of necrotizing fasciitis. All patients survived. Eight patients were male and seven were female. Patient mean age was 33 years (range 3 to 66 years). Wound defect surface area ranged from 85 to 3000cm2, mean 727 ± 220cm 2. BBSS wound coverage ranged from 46 to 2790cm2, mean 574 ± 202cm2. Engraftment of BBSS averaged 88 percent. Ultrathin skin grafts ranged from 40 to 2790cm2, mean 570 ± 213cm2. Skin graft take averaged 92 percent. Three ultrathin skin grafts required additional grafting for closure. Conclusions: BBSS followed by ultrathin skin grafting provides a satisfactory closure for large soft-tissue defects. Success rates and cosmesis are comparable to the use of this technique for closing burn wounds.
|Original language||English (US)|
|Number of pages||7|
|State||Published - Aug 1 2003|
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