Use of a collagen-elastin matrix with split-thickness skin graft for defect coverage in complex wounds

Area of Science:

• Plastic surgery
• Regenerative medicine
• Wound healing research

Background:

• Severe soft tissue damage necessitates plastic reconstructive surgery.
• Multimorbid patients or those unfit for major surgery require alternative treatments.
• Dermal substitutes like collagen-elastin matrix (CEM) with split-thickness skin graft (STSG) present an alternative to flap surgery.

Purpose of the Study:

• To compare the outcomes of CEM plus STSG using one-step versus two-step approaches.
• To evaluate the success rate of defect reconstruction in complex wounds.
• To assess the feasibility of CEM plus STSG for patients unsuitable for flap surgery.

Main Methods:

• Retrospective follow-up study of 46 patients with 49 wound sites treated with CEM and STSG.
• Analysis of 38 patients who did not require flap coverage, comparing one-step (simultaneous CEM and STSG) versus two-step (CEM with negative wound pressure therapy, then STSG) approaches.
• Mean follow-up of 22 months.

Main Results:

• Overall, 78.4% of wounds remained closed.
• The one-step approach achieved long-term defect coverage in 76.5% of wounds, while the two-step approach succeeded in 80.0%.
• No statistically significant difference in healing disorders between the one-step and two-step approaches was observed.

Conclusions:

• CEM plus STSG effectively treated 38 complex wounds, avoiding secondary flap coverage in most cases.
• Both one-step and two-step approaches demonstrated comparable efficacy for flap-free wound closure.
• A simple defect reconstruction algorithm utilizing CEM plus STSG is a successful treatment for complex wounds.