Collagen regeneration template in the management of full-thickness wounds: a prospective multicentre study.

OBJECTIVE: To evaluate the tolerance and healing rate of a collagen regeneration template in covering full-thickness wounds, including rate of adverse events. METHOD: In this prospective, multicentre study, patients with a full-thickness wound underwent two-stage surgery consisting of implantation of a collagen regeneration template followed by a split-thickness skin graft (STSG). Patients were followed-up for 12 months. Adverse events arising from either the implantation or STSG were evaluated. RESULTS: Of the 33 patients included in the study, 29 completed the full follow-up period. During the study, 13 adverse events occurred at the treated wound site, as reported by 11 patients during follow-up. These included local infection (n=5), a diffuse infection (n=1) and non-infectious seroma under the silicon layer (n=1). The mean percentage of take of the collagen template at 21±7 days after implantation was 81.2% of the treated surface. The mean percentage of take of STSG at 28 days after grafting was 84.4% of grafted surface. STSG was successful in 28 patients, but was completely rejected at 12 months for one patient. Mean functional score at 12 months, as evaluated by the treating surgeons, was 76.8/100 and mean aesthetic score was 62.7/100. CONCLUSION: This study found use of a collagen regeneration template to be a safe procedure for the coverage of full thickness-wounds.

Management of traumatic soft tissue defects with dermal regeneration template: a prospective study.

INTRODUCTION: Traumatic soft tissue defect is a common issue for the trauma surgeon. The aim of this study was to evaluate the use of a dermal regeneration template (DRT) associated to a split-thickness skin graft (STSG) to cover severe traumatic wounds involving exposure of deep functional structures. MATERIALS AND METHODS: Patients with severe traumatic defects, either open fractures or full-thickness skin wounds involving exposure of tendons without paratenon, bones without periosteum or joints without articular capsule, managed in the authors' trauma centre, were included in a prospective fashion. They were treated by DRT, associated to STSG within a month and followed up to 18 months. The primary outcome was STSG percentage of take at 18 months. The secondary outcomes included complications rate, functional results, scar retraction rate at 18 months and aesthetic results. RESULTS: A total of 15 patients were included, with 100% follow-up at 18 months. The mean age was 44.3 years, with nine men. Eighty percent of the wounds were located on the lower limb. After 18 months, the mean STSG take rate was 99.3%. Between the placement of the template and the STSG procedure, the reported complications were template unsticking, seroma, local infection and local oedema. There was no reported haematoma. In terms of functional outcome, percentages of patients undergoing rehabilitation from the time of the skin graft until the end of the follow-up decreased from 80% to 20%. There was 8.7% of retraction in length, and an 8.2% retraction in width. The Vancouver Scar Scale score constantly decreased until 2.5 at 18 months. The final functional and aesthetic subjective scores showed the marks to be located above the 'Satisfying' threshold, either by the surgeon or by the patients. DISCUSSION AND CONCLUSION: Eighteen months' follow-up demonstrated that DRT reconstruction is a simple, reliable, efficient tool to treat complex traumatic soft tissue defects.