• Myung Chul Lee, Yong Jun Jang, In Sik Yun, Dae Hyun Lew, and Won Jai Lee.
• Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Seoul, Korea; Department of Medicine, Yonsei University Graduate School of Medicine, Seoul, Korea.
• J Hand Surg Am. 2017 Apr 1; 42 (4): 297.e1-297.e10.

PurposeThe combination of acellular dermal matrix (ADM) and split-thickness skin graft (STSG) has been widely adopted to overcome functional and cosmetic limitations of conventional STSG. In this study, we evaluated the efficacy of this combination using 2 types of ADM: cadaveric acellular dermal matrix (CDM) and bovine acellular dermal matrix (BDM).MethodsWe recruited 72 patients undergoing autologous STSG to cover radial forearm free flap donor sites. They were included in 1 of 3 therapeutic groups: group 1, STSG using CDM (n = 29); group 2, STSG using BDM (n = 20); and group 3, STSG only (n = 23). Functional skin values for skin elasticity, humidification, transepidermal water loss, and color were determined. Values were compared between graft sites and adjacent normal (control) skin, and between grafted areas of each group.ResultsAll skin defects were successfully reconstructed without graft loss. Groups 1 and 2 demonstrated better elasticity than did group 3, based on the analysis using the ratio of grafted area to control. Grafted areas in all 3 groups exhibited less moisture than did control normal skin. There was less transepidermal water loss in group 1 than in group 3, which implied that CDM application had better barrier capacity against water evaporation. Graft sites of groups 1 and 3 exhibited darker and redder color compared with control areas.ConclusionsComposite forearm defects were successfully restored and exhibited acceptable quality after treatment with an ADM plus STSG. Applying either CDM or BDM under a STSG was a suitable procedure, as verified by objective measurements. Elasticity was well preserved in CDM and BDM groups. However, both ADMs revealed functional impairment of humidification.Type Of Study/Level Of EvidenceTherapeutic IV.Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

33 keywords...

hide…