J Neurol Surg A Cent Eur Neurosurg 2016; 77(04): 297-299
DOI: 10.1055/s-0035-1559810
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Acellular Dermal Matrix Combined with Autologous Skin Grafts for Closure of Chronic Wounds after Reconstruction of Skull Defects with Titanium Mesh

Xu Luo
1   Department of Wounds and Burns Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
,
Cai Lin
2   Department of Burn, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang Province, China
,
Xinling Wang
3   Department of Outpatient Services Center, The Taihe Hospital of Hubei Medical College, Shiyan, HuBei Province, China
,
Xiangwei Lin
1   Department of Wounds and Burns Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
,
Sunyue He
4   Department of Clinical Medical Sciences, The School of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
,
Yunfeng Liu
1   Department of Wounds and Burns Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
,
Yong Zhang
1   Department of Wounds and Burns Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
,
Ruijin Yang
1   Department of Wounds and Burns Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
,
Xinguo Zhu
5   Department of General Surgery, The First Affiliated Hospital of Suzhou Medical College, Suzhou Province, China
› Author Affiliations
Further Information

Publication History

20 November 2014

24 April 2015

Publication Date:
18 April 2016 (online)

Abstract

Objective The closure of chronic wounds after skull defect reconstruction with titanium mesh is one of the most challenging problems for plastic and reconstructive surgeons. Current approaches are disappointing.

Methods In 10 patients, we explored the role of acellular dermal matrix (ADM) in combination with autologous skin grafts (ASGs) for closure of chronic wounds after skull reconstruction with titanium.

Results ADM and ASG survived in all patients. Grade A healing (healing well without defect) was achieved. The average operating time was 30 to 45 minutes, and the average blood loss 30 to 50 mL. After 3 months, the wound was still closed in all patients.

Conclusion The combination of ADM plus ASG obtained a high wound closure rate. ADM plus ASG allows avoiding other procedures such as rotational flaps and free flaps that require more operating time, special equipment, and adequate training.

 
  • References

  • 1 Zhang SG, Pan TH, Zhou JF. Titanium mesh repair skull defects on temporalis muscle outside frontotemporal region. J Clin Neurosurg 2007; 4 (1) 43-45
  • 2 Sultan SM, Davidson EH, Butala P , et al. Interval cranioplasty: comparison of current standards. Plast Reconstr Surg 2011; 127 (5) 1855-1864
  • 3 Livesey SA, Herndon DN, Hollyoak MA, Atkinson YH, Nag A. Transplanted acellular allograft dermal matrix. Potential as a template for the reconstruction of viable dermis. Transplantation 1995; 60 (1) 1-9
  • 4 Wainwright DJ. Use of an acellular allograft dermal matrix (AlloDerm) in the management of full-thickness burns. Burns 1995; 21 (4) 243-248
  • 5 Takami Y, Matsuda T, Yoshitake M, Hanumadass M, Walter RJ. Dispase/detergent treated dermal matrix as a dermal substitute. Burns 1996; 22 (3) 182-190
  • 6 Martin MP, Olson S. Post-operative complications with titanium mesh. J Clin Neurosci 2009; 16 (8) 1080-1081
  • 7 Zhang YS, Zhang JN, Wang RQ , et al. Effect of different shaping methods of titanium mesh on cranioplasty. Chinese J Neurosurg Dis Res 2014; 13 (3) 263-265
  • 8 Janecka IP. New reconstructive technologies in skull base surgery: role of titanium mesh and porous polyethylene. Arch Otolaryngol Head Neck Surg 2000; 126 (3) 396-401
  • 9 Brongo S, Pagliara D, Campitiello N , et al. Reconstruction of traumatic defect of the lower third of the leg using a combined therapy: negative pressure wound therapy, acellular dermal matrix, and skin graft. Case Rep Surg 2014; 783812