*Orthopaedics, University General Hospital of Alexandroupolis, Alexandroupolis, Greece.
†Orthopaedics, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece.
J Am Podiatr Med Assoc. 2024 Mar-Apr;114(2). doi: 10.7547/22-009.
The management of complex and severe lower-extremity injuries is challenging for the orthopedic surgeon. When the primary or secondary closure of the defect is not feasible, complex procedures with graft (split-thickness or full-thickness) or flap (pedicled or free) are required. These procedures are performed by specialized plastic surgeons and are at high risk for adverse effects, even high morbidity among both the donor and acceptor sites. Furthermore, split-thickness skin grafts (STSGs) often lead to unsatisfactory results in terms of mechanical stability, flexibility, and aesthetics due to the lack of underlying dermal tissue. Consequently, dermal substitutes, such as MatriDerm (MedSkin Solutions Dr Suwelack AG, Billerbeck, Germany), have been proposed and further developed as a treatment option addressing the management of full-thickness wound defects in conjunction with STSGs. We aimed to present a case of post-traumatic full-thickness wound defect of the left foot after traumatic amputation of the digits that was treated with MatriDerm combined with autologous STSG. In addition, we performed a systematic review of the literature to delineate the efficacy of the use of MatriDerm combined with STSGs in orthopedic cases exclusively.
对于骨科医生来说，复杂和严重的下肢损伤的处理具有挑战性。当无法进行缺损的一期或二期闭合时，需要进行带有移植物（断层或全层）或皮瓣（带蒂或游离）的复杂手术。这些手术由专业的整形外科医生进行，存在很高的不良反应风险，即使是供体和受体部位的高发病率也很高。此外，由于缺乏底层真皮组织，断层皮片（STSG）在机械稳定性、柔韧性和美观方面往往导致不理想的结果。因此，已经提出并进一步开发了真皮替代物，如 MatriDerm（MedSkin Solutions Dr Suwelack AG，Billerbeck，德国），作为一种治疗选择，用于联合 STSG 处理全层创面缺损。我们旨在介绍一例创伤性断指后左足创伤性全层创面缺损的病例，该病例采用 MatriDerm 联合自体 STSG 治疗。此外，我们对文献进行了系统回顾，以明确 MatriDerm 联合 STSG 在骨科病例中的疗效。
