Pilot Study: Dermal Regenerative Templates for Complex Wound Management: Adding a New Rung to the Reconstructive...

Skin grafting with dermal regenerative templates (DRTs) has emerged as an effective option within the reconstructive ladder for coverage of full-thickness wounds. This approach reduces the need for flap reconstruction, shortens hospitalization, and minimizes wound-related morbidity while improving functional and aesthetic outcomes. We present a case series of patients treated with a novel hydrogel-based DRT (hDRT) composed of type I bovine collagen microspheres embedded within a lower density type I bovine collagen hydrogel. We describe outcomes of wounds treated using this template.

A retrospective chart review of patients who underwent definitive coverage of full-thickness skin defects with an hDRT was performed.

Thirteen defects in 10 patients underwent reconstruction. Defect locations included the face, scalp, and extremities. Wound etiologies included oncological, traumatic, and donor-site defects. Exposed tissues included tendon, bone, nerve, and galea. Defect size ranged from 2 to 100 cm². Wounds were managed using hDRT with immediate skin grafting, hDRT with delayed skin grafting, and hDRT alone without grafting. All patients displayed wound bed vascularization 8 days after application. Mean total time to healing (T _total) was 8 days for immediate skin grafting, 15 days for delayed skin grafting, and 18 days for secondary intention. All healed defects were aesthetically acceptable, with minimal to no contour deformity.

This novel dual-density hDRT demonstrated favorable results in wound reconstruction as a result of accelerated vascularization leading to reduced treatment time and patient morbidity. Larger studies are required to compare the efficacy with other products on the market.