Abstract：
UNASSIGNED: Severe soft tissue damage with destruction of the dermis requires plastic reconstructive treatment. For multimorbid patients or patients unable to undergo major reconstructive surgery, use of dermal substitutes, such as a collagen-elastin matrix (CEM) with a split-thickness skin graft (STSG), instead of local or free flap surgery, may be a valid and easy treatment option. We aimed to investigate and compare the outcomes and rate of successful defect reconstruction using CEM plus STSG, using either a one-step approach (simultaneous CEM and STSG) or a two-step approach (CEM and negative wound pressure therapy (NPWT), with secondary STSG transplantation).
UNASSIGNED: A single-centre, retrospective follow-up study of patients who had received CEM was conducted. Wounds had been treated with an STSG transplantation covering a CEM (MatriDerm, MedSkin Solutions Dr. Suwelack AG, Germany). Previous attempts at wound closure with conventional methods had failed in the selected patient population, which would usually have resulted in flap surgery.
UNASSIGNED: Overall, 46 patients were included (mean age 60.9±20.0 years), with a total of 49 wound sites. We analysed 38 patients with wounds that did not require flap coverage; 18 patients received the one-step approach and 20 patients received the two-step approach. The mean follow-up in these patients was 22±11.5 months, and one patient was lost to follow-up. Overall, 29 (78.4%) wounds remained closed. Wounds which did not successfully heal were related to comorbidities, such as diabetes, alcohol misuse and smoking. Using the one-step approach, long-term defect coverage was achieved in 13 (76.5%) wounds and 16 (80.0%) wounds were closed using the two-step approach. However, there was no statistically significant differences between the one- or two-step approaches regarding the rate of development of a wound healing disorder.
UNASSIGNED: Wound closure was achieved in 38 complex wounds using CEM plus STSG, while 11 wounds needed secondary flap coverage. In the flap-free wounds, there were no statistically significant differences between the one-step versus two-step approach. Using a simple defect reconstruction algorithm, we successfully used CEM plus STSG to treat complex wounds.
UNASSIGNED: A single-centre, retrospective follow-up study of patients who had received CEM was conducted. Wounds had been treated with an STSG transplantation covering a CEM (MatriDerm, MedSkin Solutions Dr. Suwelack AG, Germany). Previous attempts at wound closure with conventional methods had failed in the selected patient population, which would usually have resulted in flap surgery.
UNASSIGNED: Overall, 46 patients were included (mean age 60.9±20.0 years), with a total of 49 wound sites. We analysed 38 patients with wounds that did not require flap coverage; 18 patients received the one-step approach and 20 patients received the two-step approach. The mean follow-up in these patients was 22±11.5 months, and one patient was lost to follow-up. Overall, 29 (78.4%) wounds remained closed. Wounds which did not successfully heal were related to comorbidities, such as diabetes, alcohol misuse and smoking. Using the one-step approach, long-term defect coverage was achieved in 13 (76.5%) wounds and 16 (80.0%) wounds were closed using the two-step approach. However, there was no statistically significant differences between the one- or two-step approaches regarding the rate of development of a wound healing disorder.
UNASSIGNED: Wound closure was achieved in 38 complex wounds using CEM plus STSG, while 11 wounds needed secondary flap coverage. In the flap-free wounds, there were no statistically significant differences between the one-step versus two-step approach. Using a simple defect reconstruction algorithm, we successfully used CEM plus STSG to treat complex wounds.
摘要：
■严重的软组织损伤和真皮的破坏需要整形重建治疗。对于多患者或无法进行大型重建手术的患者，使用真皮替代品，例如具有分层厚度皮肤移植物（STSG）的胶原蛋白-弹性蛋白基质（CEM），而不是局部或游离皮瓣手术，可能是一个有效和容易的治疗选择。我们旨在调查和比较使用CEM加STSG的成功缺损重建的结果和率，使用一步方法（同时进行CEM和STSG）或两步方法（CEM和伤口负压治疗（NPWT），进行二次STSG移植)。
■单中心，我们对接受CEM治疗的患者进行了回顾性随访研究.伤口已经用覆盖CEM的STSG移植治疗(MatriDerm，MedSkinSolutionsDr.SuwelackAG,德国)。在选定的患者群体中，以前用常规方法进行伤口闭合的尝试失败了。这通常会导致皮瓣手术。
■总的来说，纳入46例患者（平均年龄60.9±20.0岁），共有49个伤口。我们分析了38例不需要皮瓣覆盖的伤口患者；18例患者接受了一步方法，20例患者接受了两步方法。这些患者的平均随访时间为22±11.5个月，一名患者失去随访。总的来说,29（78.4％）伤口保持闭合。没有成功愈合的伤口与合并症有关，比如糖尿病，酒精滥用和吸烟。使用一步法，采用两步法闭合13个(76.5%)伤口和16个(80.0%)伤口,实现了长期缺损覆盖.然而,在伤口愈合障碍的发生率方面,一步法或两步法没有统计学显著差异.
■使用CEM加STSG在38个复杂伤口中实现伤口闭合，而11个伤口需要二次皮瓣覆盖。在无皮瓣的伤口中，一步法与两步法之间无统计学显著差异.使用简单的缺陷重建算法，我们成功使用CEM+STSG治疗复杂伤口.
■单中心，我们对接受CEM治疗的患者进行了回顾性随访研究.伤口已经用覆盖CEM的STSG移植治疗(MatriDerm，MedSkinSolutionsDr.SuwelackAG,德国)。在选定的患者群体中，以前用常规方法进行伤口闭合的尝试失败了。这通常会导致皮瓣手术。
■总的来说，纳入46例患者（平均年龄60.9±20.0岁），共有49个伤口。我们分析了38例不需要皮瓣覆盖的伤口患者；18例患者接受了一步方法，20例患者接受了两步方法。这些患者的平均随访时间为22±11.5个月，一名患者失去随访。总的来说,29（78.4％）伤口保持闭合。没有成功愈合的伤口与合并症有关，比如糖尿病，酒精滥用和吸烟。使用一步法，采用两步法闭合13个(76.5%)伤口和16个(80.0%)伤口,实现了长期缺损覆盖.然而,在伤口愈合障碍的发生率方面,一步法或两步法没有统计学显著差异.
■使用CEM加STSG在38个复杂伤口中实现伤口闭合，而11个伤口需要二次皮瓣覆盖。在无皮瓣的伤口中，一步法与两步法之间无统计学显著差异.使用简单的缺陷重建算法，我们成功使用CEM+STSG治疗复杂伤口.
