Gupta Subhas, Moiemen Naiem, Fischer John P, Attinger Christopher, Jeschke Marc G, Taupin Philippe, Orgill Dennis P
From Loma Linda University, Loma Linda, Calif.
University of Birmingham, Birmingham, UK.
Plast Reconstr Surg Glob Open. 2024 Mar 20;12(3):e5674. doi: 10.1097/GOX.0000000000005674. eCollection 2024 Mar.
Dermal scaffolds have created a paradigm shift for burn and wound management by providing improved healing and less scarring, while improving cosmesis and functionality. Dermal regeneration template (DRT) is a bilayer membrane for dermal regeneration developed by Yannas and Burke in the 1980s. The aim of this review is to summarize clinical evidence for dermal scaffolds focusing on DRT for the management and reconstruction of burn injuries and complex wounds.
A comprehensive search of PubMed was performed from the start of indexing through November 2022. Articles reporting on DRT use in patients with burns, limb salvage, and wound reconstruction were included with focus on high-level clinical evidence.
DRT has become an established alternative option for the treatment of full-thickness and deep partial-thickness burns, with improved outcomes in areas where cosmesis and functionality are important. In the management of diabetic foot ulcers, use of DRT is associated with high rates of complete wound healing with a low risk of adverse outcomes. DRT has been successfully used in traumatic and surgical wounds, showing particular benefit in deep wounds and in the reconstruction of numerous anatomical sites.
Considerable clinical experience has accrued with the use of DRT beyond its original application for thermal injury. A growing body of evidence from clinical studies reports the successful use of DRT to improve clinical outcomes and quality of life across clinical indications at a number of anatomical sites.
真皮支架通过促进更好的愈合、减少瘢痕形成,同时改善美观和功能,为烧伤和伤口管理带来了范式转变。真皮再生模板(DRT)是20世纪80年代由扬纳斯和伯克开发的用于真皮再生的双层膜。本综述的目的是总结真皮支架的临床证据,重点关注DRT在烧伤管理和重建以及复杂伤口处理中的应用。
对PubMed进行全面检索,检索时间从数据库建立之初至2022年11月。纳入报告DRT用于烧伤患者、肢体挽救和伤口重建的文章,重点关注高级别临床证据。
DRT已成为治疗全层和深Ⅱ度烧伤的既定替代选择,在美观和功能重要的领域取得了更好的治疗效果。在糖尿病足溃疡的治疗中,使用DRT与高比例的完全伤口愈合相关联,且不良后果风险较低。DRT已成功应用于创伤性和手术伤口,在深部伤口以及众多解剖部位的重建中显示出特别的益处。
除了最初用于热损伤外,DRT在临床应用中积累了丰富的经验。越来越多的临床研究证据表明,DRT在多个解剖部位的临床适应症中成功应用,改善了临床结局和生活质量。