Therapeutic potential of dermal matrix in orthopaedic trauma

The primary aim was to examine the outcomes of dermal matrix (DM) in populations with non-closable traumatic, infectious, or post-surgical wounds managed by an orthopaedic trauma service line. The secondary aim was to identify the success and complication rates of DM, as well as attempting to document time to healing.

This was a multi-center retrospective chart review at urban community and academic affiliated trauma centers. Consecutive patients with any traumatic, infectious or post-surgical wounds treated with dermal matrix from January 2020 to August 2025. Patients were excluded if lost to follow-up and/or had ongoing treatment. Data was collected for demographics and comorbidities, alongside origin, treatment, and time to complete healing of the wound.

Seventy-three patients had application of DM on 75 wounds. Four patients were lost to follow-up, 9 had ongoing treatment, and 3 died. The final cohort consisted of 57 patients, with 59 wounds. There were 33 males and 24 females. The average age was 58 + /-19.4 years. Wound origins were postoperative (n = 17), traumatic (n = 30), and infectious (n = 12) etiologies. The average number of washouts prior to application was 2.3 + /- 1.2. Two wounds required salvage plastic surgery involving sural flaps. One wound had a failure of skin graft after DM with subsequent treatment by secondary healing via epithelialization. 55.9% (33/59) of wounds with DM healed without subsequent skin graft. Of the remaining 26 wounds, 16 were initially planned for skin grafting due to wound size. Average documented time to healing was 179.3 + /- 137.3 days, which was inflated due to lost follow-up with subsequent representation into the health system well after healing. Multiple patients in the study had wounds with exposed bone, tendon, or hardware at time of DM application.

Dermal matrix is a reliable alternative for wound management that does not require subspecialty training.