The clinical effects of artificial dermis in the treatment of skin and soft tissue defects accompanied by bone or tendon exposure.

Injury

Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou 350004, Fujian Province, PR China; Department of Emergency & Trauma Surgery, Fujian Provincial Hospital, National Regional Trauma Medical Center, No.134 East Street, Gulou District, Fuzhou 350001, Fuiian Province, PR China; Fujian Provincial Key Laboratory of Emergency Medicine, Fujian Provincial Institute of Emergency Medicine, Fujian Emergency Medical Center, Fuzhou 350001, Fujian, PR China. Electronic address:

Published: October 2024

AI Article Synopsis

  • The study aimed to evaluate the clinical effects of artificial dermis on skin and soft tissue defects related to bone or tendon exposure in 45 trauma patients from Fujian Provincial Hospital.
  • A retrospective analysis showed that while the healing time was longer in the artificial dermis group, there were no significant differences in wound assessment scales, pain scores, or skin sensation recovery compared to the control group over a follow-up period of around 13.8 months.
  • The results suggest that artificial dermis is a safe and effective treatment option for these types of injuries, despite a longer initial healing time.

Article Abstract

Objective: The clinical effects of artificial dermis in treating skin and soft tissue defects accompanied by bone or tendon exposure were assessed.

Approach: A retrospective analysis was conducted on the clinical data of 45 cases of skin and soft tissue defects accompanied by bone or tendon exposure admitted to the trauma surgery department of Fujian Provincial Hospital between February 2018 and August 2020. They were divided into the artificial dermis and control groups. The wound was assessed using the Vancouver Scar Scale (mVSS), and the postoperative visual analogue scale (VAS) scores were recorded at 3, 6, 9, and 12 months after surgery. At the 12-month after surgery, skin sensation recovery was evaluated using the criteria of the British Medical Research Council (BMRC).

Results: The cases included 26 males and 19 females, aged 50 to 85 years. All patients were followed up for an average of 13.8 months (range: 12-18 months). Compared with controls, the wound healing time of the observation group was longer (35.8 ± 10.6 vs. 28.5 ± 4.8, P = 0.007), without significant differences for the number of operations and length of hospitalization. The mVSS scores were not different between groups (P = 0.294), but the scores decreased with time (P < 0.001), and the group×time interaction was significant (P < 0.001). Similarly, the VAS scores were not different between groups (P = 0.667), but the scores decreased with time (P < 0.001); the group×time interaction was not significant (P = 0.274). At the 12-month mark following the operation, in the artificial dermis group, the MCRR score was S3+ in 23 patients, while it ranged from S0 to S3 in two patients; in the control group, S3+ was observed in 17 patients, and S0-S3 in three (P = 0.815).

Conclusion: Artificial dermis treatment is considered a safe and effective alternative therapy for patients with skin and soft tissue defects accompanied by bone or tendon exposure who cannot tolerate or are unwilling to undergo autologous skin flap transplantation. It offers the advantages of minimal donor site trauma, simplicity in operation, and favorable postoperative functional recovery.

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Source
http://dx.doi.org/10.1016/j.injury.2024.111755DOI Listing

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