Assessment of Biological Response of Cadaver Dermal Allograft in Burn and Non Healing Ulcer Wounds

Objectives: The purpose of the study was to place cadaverdermal allograft in patients with burn and non-healing ulcerwounds and observe their biologic response.1. To identify clinical success rate of take of cadavericdermal allograft2. To evaluate infection / rejection rate of cadaveric dermalallograft3. To confirm take of allograft by histological features andneovascularization after applying cadaveric dermalallograft.Method: This study was done on 50 patients suffering fromburn and nonhealing ulcer wounds. Patients of all age groupsand both sexes were taken. Dermal allografts were harvestedfrom cadaver after taking consent from relatives. These graftswere applied to wound sites after treating it with glycerol andcryopreservation and their biological responses wereassessed.Results: In this study, on follow up for 2 months, out of 50patients, the graft was survived in 41 (82%) patients andrejected in 9 (18%) patients. Out of 41 patients, the graft wasdetached and wounds were completely healed in 33(66%)patients and graft was still intact in 8(16%) patients. Graft takeup success was assessed by histopathologically showingneovascularization.Conclusion: It was observed that epidermis depleted allografthas proved to be an effective material for wound coverage dueto absence of langerhans cells. Further cryopreservationincreased its viability and reduced immune reaction. Glycerolacted as an effective virucidal agent.

Clinical and Radiological Results after Arthroscopic Superior Capsular Reconstruction in Patients with Massive Irreparable Rotator Cuff Tears

BACKGROUND: Massive, irreparable rotator cuff tears (RCTs) are a challenging clinical problem in young patients. In recent years, arthroscopic superior capsular reconstruction (ASCR) is a popular treatment in the massive, irreparable RCTs. However, studies reporting clinical results of ASCR are rare in the literature. METHODS: Between 2013 and 2015, six patients underwent ASCR. One patient treated with dermal allograft, while five patients with autogenous fascia lata graft. Demographic data, as well as preoperative and last follow-up clinical data including pain, range of motion (ROM), strength, American Shoulder and Elbow Surgeons system, the Constant system, the University of California at Los Angeles system, the Simple Shoulder Test, and the Shoulder Pain and Disability Index system were obtained. Acromiohumeral distances and Hamada classification were measured on standard anteroposterior x-ray. RESULTS: All patients were men, and the average age was 59.5 ± 4.18 years (range, 53–65 years).The minimum follow-up was 18 months with a mean follow-up was 27.33 ± 7.58 months (range, 18–36). All patients had postoperative improvement in pain scores and functional scores. The ROM and strength did not improve after surgery. The Hamada score progressed of radiographic stage in 2 patients. In the case of dermal allograft, there was graft failure 6 weeks after ASCR. CONCLUSIONS: Our results support the ASCR as a viable treatment for surgical salvage in massive, irreparable RCTs. This treatment option may provide patients with decreased pain and increased function. And studying our case of dermal allograft failure provides opportunities to decrease graft failure in ASCR using dermal allograft.

Reconstruction of Contracted Anophthalmic Socket with Acellular Dermal Allograft

PURPOSE: To study the use of acellular dermal allografts for the reconstruction of contracted anophthalmic sockets. METHODS: A retrospective analysis was performed on 12 patients with contracted sockets who underwent reconstructive surgery using acellular dermal allografts from 2002 to 2006. RESULTS: The mean age of the patients was 44.4 years. The mean duration of conjunctival sac contracture after removal of the eyeball was 21.4 years. In 4 patients, acellular dermal allografts were used as spacer grafts to elevate the eyelids, and in 8 patients the allografts were used as a conjunctival grafting material. All patients were able to wear ocular prostheses comfortably 2.2 months after surgery with acceptable cosmesis. There were no serious complications, such as infections or graft rejections during follow-up period. CONCLUSIONS: When used as conjunctival grafting materials and tarsal substitutes to elevate patients' eyelids, acellular dermal allografts gave cosmetically and functionally acceptable results in the surgical rehabilitation of contracted sockets.

Wrapping of Porous Orbital Implant Using Acellular Dermal Allograft

PURPOSE: To investigate the results when using the acellular dermal allograft (SureDerm(R), Hans Biomed Co., Korea) as a new wrapping material for porous orbital implants. METHODS: The charts of 11 patients who underwent either primary or secondary insertion of Medpor(R) orbital implants after enucleation or a new insertion after removal of previous orbital implants were reviewed. Medpor(R) orbital implants either 18 or 20 mm were wrapped with SureDerm(R) in 4x4 cm sections that were 1-mm-thick. Four rectus muscles were fixed to the SureDerm(R) wrapped implant, and a conjunctival suture was made with 6-0 Vicryl. All patients had follow-up periods longer than 10 months and were evaluated to determine the success of wrapping and to identify any complications. RESULTS: The average age of the patients was 48.3 years. The patients wore artificial eyes for 9 weeks after the operation, and the follow-up periods were 22.4 months on average. There was no case of implant or SureDerm(R) exposure, inflammation, and other significant complications except in one case that required fornix reconstruction to allow the subject to wear an artificial eye. CONCLUSIONS: Acellular dermal allograft appears to be a good substitute material if preserved sclera is not available when inserting orbital implants with wrapping.

Treatment of Exposed Hydroxyapatite Orbital Implant Using Acellular Dermal Allograft

PURPOSE: To investigate the results of acellular dermal allograft (SureDerm(R), Hans Biomed Co., Korea) as a new covering material in the exposure of hydroxyapatite orbital implant. METHODS: SureDerm graft was performed in 5 patients with exposed hydroxyapatite orbital implant. Under local anesthesia, the anterior surface of the exposed implant was trimmed and the designed SureDerm was sutured at the margin of the sclera with 6-0 Vicryl. Finally, conjunctival suture was done. The patients were followed up regularly until postoperative 10 months. RESULTS: The average diameter of exposed implant was 9.6 X 9.0 mm. The grafted SureDerm had survived in all patients at postoperative 10 months and exposure of implant was treated successfully in all cases. CONCLUSIONS: We consider that acellular dermal allograft will be a good replacing material when preserved sclera is not available. It also features the advantage of avoiding the intricate harvesting procedure and the scarring of the donor site in dermo-fat graft.

Correction of Facial Soft Tissue Defects Using Acellular Human Dermal Allograft

The augmentation of soft-tissue defects in the facial region is a challenging task for plastic and reconstructive surgeons. Numerous materials, both autologous and nonautologous materials including alloplastic implants, have been used for augmentation of soft-tissue defects of the face. Each has its limitations. There is no ideal material for soft-tissue augmentation. Acellular human dermal allograft (Alloderm, LifeCell Corporation, Woodlands, Texas, U.S.A.) combines the benefits of autografts and allografts. Alloderm does not appear to be resolved, it is a much more cost- effective treatment than fat injection, collagen injection, or other treatments that require multiple surgical operations or repeated application. Using Alloderm eliminates the need for creating a donor site. The authors report its use in 13 patients who have soft-tissue defects in the face. No serious complications such as rejection, absorption, dislocation, or extrusion were encountered. Alloderm appears to be an easily handled, safe material to use as an implant for permanent soft-tissue augmentation. Further long-term tudies are warranted to monitor the persistent volume maintenance of Alloderm.

Various Clinical Applications of Human Dermal Allograft(AlloDerm(R))

No abstract available.