Management of Hardware-Exposed Soft Tissue Defects Using Dermal Substitutes and Negative Pressure Wound Therapy

Area of Science:

• Orthopedic Surgery
• Wound Healing
• Regenerative Medicine

Background:

• Complex extremity injuries often require advanced reconstructive techniques.
• Hardware exposure after fracture fixation presents a significant reconstructive challenge.
• Flap surgery has been the traditional treatment for hardware-exposed wounds.

Purpose of the Study:

• To evaluate the efficacy of combining artificial dermal substitutes (MatriDerm) with negative pressure wound therapy (NPWT) for hardware-exposed wounds.
• To investigate a novel treatment approach for complex posttraumatic skin defects.
• To determine if this combined therapy can be an alternative to flap surgery.

Main Methods:

• A cohort of 14 patients with hardware-exposing wounds underwent debridement, MatriDerm placement, and NPWT.
• A staged approach was used to prepare wounds for MatriDerm-augmented skin grafting.
• Treatment duration and NPWT changes were stratified by injury type.

Main Results:

• Skin grafting was successful in all 14 patients.
• Open fractures required significantly longer NPWT duration compared to closed fractures.
• Patients with open fractures underwent a mean of 6.6 NPWT changes versus 2.5 for closed fractures.

Conclusions:

• Combined NPWT and artificial dermis (MatriDerm) augmented skin grafting is a useful treatment for hardware-exposed wounds.
• This approach provides a viable alternative to flap surgery in complex cases.
• The treatment effectively facilitated wound closure in challenging posttraumatic defects.