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Review
. 2023 Jul 11;6(4 Suppl):e237.
doi: 10.1097/OI9.0000000000000237. eCollection 2023 Jul.

The use of xenogenic dermal matrices in the context of open extremity wounds: where and when to consider?

Nainisha Chintalapudi  1 , Olivia M Rice  1 , Joseph R Hsu  1
Affiliations
Review

The use of xenogenic dermal matrices in the context of open extremity wounds: where and when to consider?

Nainisha Chintalapudi et al. OTA Int. .

Abstract

Optimal treatment of orthopaedic extremity trauma includes meticulous care of both bony and soft tissue injuries. Historically, clinical scenarios involving soft tissue defects necessitated the assistance of a plastic surgeon. While their expertise in coverage options and microvascular repair is invaluable, barriers preventing collaboration are common. Acellular dermal matrices represent a promising and versatile tool for orthopaedic trauma surgeons to keep in their toolbox. These biological scaffolds are each unique in how they are used and promote healing. This review explores some commercial products and offers guidance for selection in different clinical scenarios involving traumatic wounds.

Keywords: acellular dermal matrix; biological scaffolds; skin coverage; soft tissue injury.

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Conflict of interest statement

Dr. J. R. Hsu reports consultancy and speaker fees for Stryker, consultancy and speaker fees from Smith & Nephew speakers' bureau, speaker fees from Integra Lifesciences, and speaker fees from Depuy/Synthes. All other authors have no competing interests to disclose.

Figures

FIGURE 1.
FIGURE 1.
Description and names of common acellular dermal matrices.
FIGURE 2.
FIGURE 2.
Decision-making flow diagram for selection of xenogenic dermal substitutes in the management of traumatic extremity injuries.
FIGURE 3.
FIGURE 3.
A, AP and lateral views of initial injury treated with (B) serial debridements and antibiotic bead placement with external fixation. Definitive fixation was performed with (C) distraction osteogenesis in a circular external fixator for several months followed by intramedullary nail placement across the docking site. After circular frame was removed, (D) a chronic wound with exposed bone was present on the anterior tibia. Aggressive debridement was performed initially, and bone vascularity was noted to be poor. Porcine urinary bladder matrix (UBM) powder was first placed followed by layered UBM and left in place for 3 weeks, resulting in (E) a healthy layer of granulation tissue filling the wound bed. After gentle irrigation and debridement, (F) a split thickness skin graft was applied. G, The anterior tibia defect was completely healed without complications of infection or need for further ADM application.
See this image and copyright information in PMC

References

    1. Sorg H, Tilkorn DJ, Hager S, et al. . Skin wound healing: an update on the current knowledge and concepts. Eur Surg Res. 2017;58:81–94. - PubMed
    1. Simman R, Mari W, Younes S, et al. . Use of hyaluronic acid-based biological bilaminar matrix in wound bed preparation: a case series. Eplasty. 2018;18:e10. - PMC - PubMed
    1. Polfer EM, Tintle SM, Forsberg JA, et al. . Skin grafts for residual limb coverage and preservation of amputation length. Plast Reconstr Surg. 2015;136:603–609. - PubMed
    1. Taras JS, Sapienza A, Roach JB, et al. . Acellular dermal regeneration template for soft tissue reconstruction of the digits. J Hand Surg Am. 2010;35:415–421. - PubMed
    1. Geiger SE, Deigni OA, Watson JT, et al. . Management of open distal lower extremity wounds with exposed tendons using porcine urinary bladder matrix. Wounds. 2016;28:306–316. - PubMed