90th Annual Meeting Abstracts
Application of Tissue Engineered Dermal Regeneration Matrix for Complex Wound Closure
*Kushi B Bhatt, MD, *Frederick N Eko, *Jedidiah G Almond, MD, *Rodrigo Sangamarina, MD
Berkshire Medical Center, Pittsfield, MA
Background: The estimated cost of chronic wounds associated with diabetic neuropathy alone in the United States was $85 billion in 2003. In addition, complex wounds may occur from trauma, peripheral vascular disease, pressure ulcers, operative defects and other causes. Such wounds are difficult to treat and traditional methods of wound closure such as skin grafts, local or regional flaps and free tissue transfers are not always successful. Such methods may fail due to poor wound vascularity, thrombosis, infections or other local problems. Concomitant donor site morbidity or loss of function may also occur.
Introduction: Integra (Integra Life Sciences Corp., Plainsboro, NJ) is a dermal matrix of cross-linked bovine collagen with an overlying silicone membrane. Recently, there have been reports of successful Integra use for wound closure. We report a series of fourteen complex wounds treated successfully with Integra placement.
Methods: We present fourteen complex wounds successfully treated with dermal regeneration matrix (Integra). Wounds included extremity wounds, defects from operative excisions, third degree burns and a degloving penile injury. Treatment began with operative wound debridement and application of Integr, anchored with a VAC system. Operative defects were closed primarily with Integra. Twenty-one days later, the polysiloxane layer was removed and a skin graft applied. The VAC system was reapplied for 5 additional days to secure the graft.
Conclusion: Tissue engineered dermal regeneration matrix can be used successfully for complex wound closure. This method is well tolerated by patients, protects exposed bone and tendon, restores function and minimizes donor site morbidity. It also accelerates wound healing and decreases morbidity and hospital stay.