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Acellular dermal matrices in hand reconstruction.

Chandra V Ellis1, David A Kulber

  • 1Los Angeles, Calif. From the Keck School of Medicine of the University of Southern California, Cedars Sinai Medical Center.

Plastic and Reconstructive Surgery
|October 26, 2012
PubMed
Summary
This summary is machine-generated.

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Acellular dermal matrix (ADM) offers versatile solutions for forearm, wrist, and hand reconstruction, particularly in soft-tissue and ligament repair. Further comparative trials are needed to solidify its role in upper extremity surgery.

Area of Science:

  • Biomaterials Science
  • Orthopedic Surgery
  • Plastic Surgery

Background:

  • Acellular dermal matrix (ADM) is increasingly utilized in reconstructive surgery.
  • Its application in forearm, wrist, and hand reconstruction is an evolving area.
  • The review focuses on ADM for soft-tissue repair and ligament reconstruction in these specific anatomical regions.

Purpose of the Study:

  • To review the current literature on the use of acellular dermal matrix (ADM) in forearm, wrist, and hand reconstruction.
  • To analyze indications, surgical techniques, clinical outcomes, and complications associated with ADM use in these areas.

Main Methods:

  • A comprehensive literature search was conducted across multiple databases (Cochrane, MEDLINE, PubMed, Web of Knowledge).
  • Search terms included "acellular dermal matrix" and specific anatomical locations (forearm, wrist, hand).

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  • Data extraction focused on studies detailing ADM in soft-tissue repair and ligament reconstruction, excluding specific types of articles.

    • Main Results:

    • Over 100 articles published between 1994 and 2011 were reviewed.
    • ADM is most commonly used in burn reconstruction but also shows utility in ligament and joint reconstruction for conditions like carpometacarpal arthritis.
    • Concerns regarding infection were noted with porcine matrix in basal joint arthritis.

    Conclusions:

    • The clinical indications for acellular dermal matrix (ADM) in upper extremity reconstruction have expanded.
    • Hand surgeons are cautiously adopting ADM to minimize donor-site morbidity.
    • More comparative prospective trials are necessary to further establish ADM's efficacy and refine its application in hand surgery.