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Tissue Characterization after a New Disaggregation Method for Skin Micro-Grafts Generation
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Single-stage Composite Skin Reconstruction Using a Dermal Regeneration Template.

Pamela A Rudnicki1, Boonyapa Purt2, Daniel True2

  • 1Department of General Surgery, Keesler Medical Center, Keesler Air Force Base, Biloxi, Miss.

Plastic and Reconstructive Surgery. Global Open
|April 21, 2020
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Single-stage bilayer reconstruction (SSBR) with Integra and skin grafts offers a practical approach for burn wound reconstruction. This method shows reasonable graft take, potentially reducing the need for multiple procedures.

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Area of Science:

  • Regenerative Medicine
  • Plastic Surgery
  • Wound Healing

Background:

  • Composite reconstruction often requires two procedures, increasing anesthetic and hospitalization time.
  • Single-stage dermal substitute and skin graft use has been reported in limited series.
  • This study evaluates single-stage skin reconstruction using Integra and split-thickness skin graft.

Purpose of the Study:

  • To report the experience with single-stage bilayer reconstruction (SSBR) for burn wound coverage.
  • To assess the efficacy of SSBR in post-burn eschar excision and scar contracture release.
  • To evaluate graft take rates in single-stage reconstructions.

Main Methods:

  • Retrospective review of consecutive operations from 2013 to 2017.
  • Inclusion criteria: single-stage bilayer reconstruction (SSBR) procedures.
  • Data collected from electronic medical records and perioperative photographs.

Main Results:

  • 13 surgical sites in 8 subjects underwent SSBR over a 5-year period.
  • Average and median graft take were 86.2% and 95%, respectively.
  • Graft take exceeded 90% in 10 out of 13 cases; one case required regrafting.

Conclusions:

  • SSBR is a practical technique for specific burn wound reconstructions, yielding good graft take.
  • Maintaining non-contaminated wound beds is critical for successful SSBR.
  • Further research is recommended to evaluate SSBR's impact on contraction, function, and skin quality.