Biologic Dermis Graft

Abstract

In planning reconstruction for wounds, efforts should include choosing the safest and least invasive method with a goal of achieving optimal functional and cosmetic outcomes. Although a variety of methods can be used to cover defects, skin grafting is generally straightforward with a relatively low risk of complications. However, the two major concerns of skin grafting are poor matching of colors in the recipient site and donor site morbidity. To minimize the limitations of the classic skin graft, the author has developed an autogenous dermis graft, which is a deepithelialized skin graft, and has reported promising results on the coverage of small- to medium-sized wounds. The important aspects of this method include the immediate return of the epidermis to the donor site, thereby overcoming donor site morbidity and minimizing pigment mismatch between the graft and the surrounding skin by restoring the epidermal portion of the recipient site through inducing epithelization from the adjacent skin. To make the autogenous dermis graft even easier, the author has also used allogenic and artificial dermis for surface grafts. Based on the author’s experience, allogenic dermis is difficult to be taken by the wound bed. In addition, resultant scar after wound healing is usually not satisfactory. In the case of artificial dermis, clinical results are generally acceptable. Collagen sponge and hyaluronic acid sheet are two main commercial materials that are frequently used. In this chapter, the author presents the reliability of these biologic dermis grafts for wound coverage.