TITLE:
Management of Complex Wounds with Dermal Substitute Assisted by a Negative Pressure System
AUTHORS:
Cuahutémoc Márquez Espriella, Ruiz Garza Jorge Gerardo, Barbosa Villarreal Fernando, Dávila Díaz Rodrigo, Cuervo Vergara Marco Antonio, Campollo López Ana Priscila, Gutierrez Alvarez Mauricio, Chama Naranjo Alfredo, García Corral Jesús Ricardo, Pérez Benítez Omar Alberto, Pulido López Ricardo Alberto, Jaimes Duran Edwing Michel, Garibaldi Bernot Mauro, Cortes Aguilar Carlos Manuel, García Córdova Carlos Emiliano, Camacho Rodriguez Hayah, Camacho Rodriguez Hayah, Martinez Villalobos Claudia Nallely, Ochoa Contreras Erick Cesar, Randall Cruz Soto, Herrera Lozano Luis Arturo
KEYWORDS:
Negative Pressure Wound Therapy, Complex Wound, Dermal Matrix, Wound Therapy
JOURNAL NAME:
Modern Plastic Surgery,
Vol.13 No.4,
August
17,
2023
ABSTRACT: Introduction: The standard treatment for complex wound care is autografting. The advent of dermal substitutes has provided a novel tool for the preparation of the bed to be grafted. However, most types of dermal matrices require the application of a skin graft a second time. Currently, other strategies have been developed to improve the vascularization process, such as negative pressure wound therapy (NPWT), which has been reported to reduce the time required for vascular growth and dermal matrix integration and thus achieve a shorter waiting period for autologous graft application. The present study aims to evaluate the effectiveness and safety of dermal matrix management associated with NPWT in the treatment of complex wounds. Methods: Seven patients with a diagnosis of complex wounds were enrolled in this study between July 1, 2015, and June 31, 2016. After debridement and having an adequate wound bed, patients who met the criteria for the application of combined therapy were treated with dermal substitutes and a negative pressure system. The percentage of graft integration into the wound bed, complications, length of hospital stay, and duration of therapy were analyzed. Results: The mean age was 42.5 ± 16 (39 - 54) years old; three women and four men were included in the study. The approximate size of skin loss was 120.7 ± 75 cm2 (25 - 250 cm2). The combined therapy of dermal matrix plus NPWT was instituted in all cases for a period of 14 days. There were no complications, with 100% graft integration in 6 of 7 cases. Patients were discharged after a mean hospital stay of 5.4 days. Conclusions: This study demonstrates that the utilization of combined dermal matrix plus NPWT therapy can be performed safely and effectively in patients with complex wounds with low complication rates and a short hospital stay.