ABSTRACT
PURPOSE: Matriderm(R) is a highly porous dermal substitute consisting of a collagen matrix (collagen type I, III, and V) cross-linked to an elastin hydrolysate. The 1 mm thickness Matriderm(R) is used in a one-stage procedure. On the other hand, 2 mm thickness Matriderm(R) has been used in two-stage procedures in combination with split thickness skin grafts (STSG) for reconstruction as dermal substitute. To the best our knowledge, there is no case that reports the single stage procedure with 2 mm thickness Matriderm(R). There are many expected advantages if a two-stage surgery could be performed by one-stage procedure as long as the result is guaranteed. The purpose of this study is to present capacity of 2 mm thickness Matriderm(R) as a dermal substitute in single stage skin grafting by the successful results of six cases. METHODS: We performed this one-stage procedure in five patients instead of soft tissue reconstruction. Those patients were required soft tissue reconstruction after trauma injuries or radial forearm harvest as a donor site in the period between 2011 and 2012. Five Patients were treated with a combination of STSG and 2 mm thickness Matriderm(R) solely. Three out of five patients who were injured by trauma got transplanted splint thickness skin that were range from 4/1000~8/1000 inches (Table 1). Patients' data were analyzed retrospectively by chart review and patients interviews. Each patient's chart was reviewed for age, gender, type of injury, complications, final outcome and successful rates. RESULTS: The patient group consisted of 4 men and 1 woman between ages of 5 and 70. The clinical results of these five treated patients concerning skin-quality and coverage of exposed soft tissue were very good. Using 2 mm thickness Matriderm(R) the wound could gain more dermal substitute compare to 1 mm thickness Matriderm(R). CONCLUSION: Matriderm(R) is a single-use three-dimensional matrix composed of native, structurally intact collagen fibrils and elastin for supporting dermal regeneration. In this study five patients with trauma injuries or radial forearm harvest as a donor site were treated with 2 mm thickness Matriderm(R) as a dermal substitute and STSG as a single-stage procedure to cover exposed structures. Compare to 1 mm Matriderm(R), 2 mm thickness Matriderm(R) provide more dermal collagen and enhance skin-elastisity. Achieving single stage STSG with 2 mm thickness Matriderm(R), patient's hospital days were reduced in half and infection chances were also decreased. In conclusion, single skin grafting with 2 mm thickness Matriderm(R) is feasible and it is time-effient and cost effective procedure.