Free Flap Donor Site Reconstruction: A Prospective Case Series Using an Optimized Polyurethane Biodegradable...

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Plastic Surgery

Background:

• A previous 10-patient series used a biodegradable polyurethane matrix for free flap donor site reconstruction.
• Modifications to the matrix seal thickness, bonding, and fenestrations were made based on pilot study findings.
• The optimized matrix was developed to improve neodermis formation and graft integration.

Purpose of the Study:

• To evaluate the efficacy of an optimized biodegradable temporizing matrix in a second cohort of patients undergoing free flap donor site reconstruction.
• To document the integration, delamination, and autograft take with the modified matrix.
• To assess long-term outcomes, including scar appearance and matrix degradation.

Main Methods:

• The optimized biodegradable temporizing matrix was implanted at the free flap donor site.
• Matrix integration was monitored for approximately five weeks.
• Delamination of the matrix seal, dermabrasion, and autologous split-skin grafting were performed for definitive closure.

Main Results:

• Complete and uncomplicated matrix integration occurred in all patients.
• Matrix seal delamination was consistently achieved in one piece.
• Autologous split-skin graft take was 100% in all cases, with improved long-term scar outcomes compared to the pilot group.
• The matrix degraded completely within 12 months, with minimal residual microscopic remnants.

Conclusions:

• The optimized biodegradable temporizing matrix is safe and effective for human implantation in free flap donor site reconstruction.
• Neovascularization and integration of the matrix were confirmed.
• No infections were observed, and split-skin grafting was successful, indicating good clinical outcomes.