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Updated: Jul 13, 2026
Tissue Characterization after a New Disaggregation Method for Skin Micro-Grafts Generation
Published on: March 4, 2016
The use of the acellular dermal matrix in microtia reconstruction to decrease donor site morbidity after
Maria Ida Rizzo1, Jacopo Maria Frattaroli1, Francesca Nascimben2
1Plastic and Maxillofacial Surgery Unit, Cleft and Craniofacial Center, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Purpose:
To determine whether and how the use of an acellular dermal matrix (ADM) underneath a scalp flap after temporal fascia harvest reduces postoperative donor-site complications in microtia surgery.
Methods:
This case‒control study included patients with congenital microtia who underwent primary ear reconstruction with porous polyethylene implants between 2018 and 2021. Group No-ADM patients (2018-2019), Group ADM patients (2020-2021). The skin quality outcomes of the scalp flap after temporal fascia harvest were analysed through pinch tests and ultrasound imaging. Aesthetical and psychosocial outcomes were tested with standardized questionnaires that were administered to the patients and their parents.
Results:
20 patients (60 % male), 8 (40 %) in the No-ADM group and 12 (60 %) in the ADM group. Re-do surgery rate was higher in the No-ADM group than in the ADM group (17.5 % vs 5 %; p < 0.05). The pinch test was used to assess the recovery of tissue elasticity in the 100 % ADM group, and it was negative in the 75 % No-ADM group (p < 0.05). The median US thickness was 4.87 mm in the No-ADM group and 4.48 mm in the ADM group (p = 0.37). Aesthetic analysis revealed higher satisfaction levels among patients in the ADM group than in those in the non-ADM group. There was no significant difference in terms of quality of life between the two groups.
Conclusions:
ADM use decreases local morbidity after facial harvest in the temporoparietal region. The greater thickness of the skin in the No-ADM group despite the absence of the ADM was probably due to greater fibrogenesis, which was limited by the ADM in the ADM group. In conclusion, ADM reduces the risk of postoperative subcutaneous scar adhesions.
