Utilisation de Matriderm® 1 mm en chirurgie reconstructrice. Série de 31 cas

Abstract

Dermal substitute are used for soft-tissue defect for their functional and aesthetic advantages. Matriderm® 1mm, single layer dermal matrix, composed of collagen and elastin covered by a split thickness skin graft simultaneously to its application, has been used most often in burned surgery. This prospective series evaluates the interest of this recent dermal matrix in reconstructive surgery. Twenty-eight patients have been treated with the substitute in our department for reconstructive surgery indication between November 2008 and May 2012. Indications were tissue losses treatment after limb or trunk sarcoma resection, melanoma, extended baso- or spinocellular carcinoma, palmoplantar keratodermy, burn sequels, or traumatic tissue losses. Indications were preferentially deep tissue losses, functional areas and the face. Mean treated area has been 82.4 cm(2) (10 to 600 cm(2)). Mean taken rate has been 87±19% of the area and mean day of discharge has been 4.8 days and the mean cost per patient 906.5 euros. Negative wound therapy, until D3, was used 6 times. Three patients treated for limb sarcoma had radiotherapy performed on the grafted area. Aesthetic and functional results have been encouraging. Matriderm® 1mm, dermal substitute commonly used in acute burn treatment can be indicated in reconstructive surgery. This series show that it permits to obtain a good graft taken rate, a quick healing with a satisfying aesthetic and functional results and permit an early discharge. However, its indications are limited by its cost.