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Review Of Dermal Regeneration Templates In Civilian Extremity Reconstruction
Terri Zomerlei MD
Corinne Wee BA
Diana Carrau MD
Joseph Meyerson MD
Ian Valerio MD, MS, MBA
The Ohio State University
2017-02-15
Presenter: Terri A. Zomerlei
Affidavit:
This research is approved and has been the original work of the resident and co-authors.
Director Name: Gregory Pearson MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background:
Reported military experiences with use of dermal regeneration templates (DRTs) have shown tremendous benefit in optimizing the outcomes in complex extremity reconstructions. Similar to the reported military series, civilian-based trauma and oncologic extremity reconstructions may also benefit from application of DRTs in complex wounds.
Methods:
An IRB approved retrospective study of a single surgeon consecutive DRT case series spanning over a two-year period was completed. Patient demographics, wound location information, follow up, and DRT and skin grafting take were recorded and analyzed.
Results:
The review included 28 total cases employing a DRT with 23 of these cases involving an extremity or residual limb defect. Patient follow-up ranged from 1-25 months. The DRTs were employed over many regions both distal and proximal in the upper and lower extremity. In the majority of cases, exposed vital structures such as bone, tendon, nerve, joint capsule, and vasculature structures were encountered. DRTs proved successful in providing viable, stable coverage of these exposed vital structures while providing an acceptable vascularized dermal construct for second stage skin grafting. The patients in the series experienced a >95% successful take both of the DRT the second stage autologous skin graft. Preservation of joint mobility and extremity motion was achieved in all cases.
Conclusion:
In military and civilian extremity reconstructions, DRTs have provided reliable regenerative, vascularized constructs for skin grafting in complex wound conditions while contributing to improved functionality.
