Effect of porcine acellular dermal matrix temporarily cover combined with flap pedicle replantation for repairing the donor site of abdominal flap

Abstract

Objective To observe the effect of porcine acellular dermal matrix temporarily cover and flap pedicle replantation for repairing the donor site of abdominal flap. Methods From January 2010 to December 2016, 21 patients suffered from deep electric burns, hot crush injuries, soft tissue defects after trauma with internal fixation exposure on elbow, forearm and hand, were treated in Beijing Jishuitan Hospital. After wound debridement, the soft-tissue defect sizes were 7 cm×6 cm- 11 cm×9 cm. Abdominal flaps were cut to repair above wounds respectively. The pedicle and part of donor site of the abdominal flap were temporarily covered with porcine acellular xenogeneic dermis matrix. Flap pedicle was modified and replanted to the donor site of the abdomen flap when pedicle was separated. Flap survival, tissue under the flap infection, liquefaction, necrosis, the complications of the donor site were observed after outpatient follow-up. Results Flap survival was complete in all 22 wounds of 21 patients, the flaps created were 10 cm×7 cm- 18 cm×11 cm, the width of flap pedicle were 8 - 10 cm in 20 flaps, and the remaining 2 flaps had a pedicle width of 7 cm and 11 cm, respectively. A total of 4 random flaps, 16 iliovaginal flaps and 2 thoracic-umbilicus flaps were used. No tissue infection, liquefaction, necrosis occurred under the flaps. No infection, hematoma, seroma and wound dehiscence happened on the donor site. During a fellow-up of 6-24 months, there were only light linear scars in the fiap of donor site, and the appearance was satisfactory. Conclusions When abdominal flap is used to repair elbow joint to hand wound, the small and medium area of the flap donor site and skin flap pedicle are temporarily closed with porcine acellular dermal matrix. When the flap pedicle is separated, the pedicle is transplanted back to the flap donor site to prevent postoperative complications in the flap donor site, and can avoid skin graft in the flap donor site and improve local appearance. The method is simple, easy, safe and reliable. Key words: Wounds and injuries; Surgical flaps; Skin transplantation; Wound healing; Swine; Acellular dermal matrix; Flap pedicle replantation; Donor site