Autologous Dermal Graft Research Articles

Heterologous Dermal Graft (Alloderm) after Plaque Excision in Peyronie'S Disease. First Experience

Several reconstructive surgical techniques have been developed for correction of penile curvature in Peyronie's disease. In some cases plaque excision and grafting with various autologous tissues or synthetic material are performed. Autologous dermal graft is the most commonly used. Today a cadaveric dermal allograft as fully decellularized dermal matrix is available (AlloDerm). This clinical study evaluated the capacity of AlloDerm allograft dermal matrix to function as a permanent dermal transplant and potentially enhance the quality of grafts applied to penile albuginea defect after plaque excision in five patients with Peyronie's disease. Biopsy specimens were obtained from 2 patients at 4 months to test revascularization and adherence of the graft.

Laser-assisted dermal grafting for the correction of cutaneous contour defects.

The correction of dermal loss as occurring in acne and other atrophic scars as well as the cosmetic correction of deep rhytides may be attainable by many techniques. When autologous tissue is desired by the patient or when a larger procedure is not desired then autologous dermal grafting is often a satisfactory solution. Eleven patients had 32 dermal grafts implanted for cutaneous contour defects. Various methods of harvesting and implanting dermal grafts are described. A high-energy short-pulse CO2 laser is used to prepare the donor site. Dermal grafts are an attempt to provide safe autologous and permanent correction for deeper cutaneous contour problems. Most patients achieve adequate correction of their contour defect. Complication rate is low although early in our experience epidermal cyst formation (2/32) and tethering (1/32) were seen. Suggestions for avoidance of these problems are offered. In two grafts resorption or partial resorption was seen. Dermal grafting is a useful adjunctive technique in the management of deeper acne scars, and rhytides. It seems to be a safe reproducible technique that should become part of the dermatologic surgeon's armamentarium.

The Laser Dermal Implant™: A New Technique for Preparation and Implantation of Autologous Dermal Grafts for the Correction of Depressed Scars, Lip Augmentation, and Nasolabial Folds Using SilkTouch™ Laser Technology

Autologous dermal grafting is a promising method for correction of depressed scars and rhytides and for lip augmentation. In this article, we describe an original technique to obtain and implant dermal grafts. Using SilkTouch™ laser technology and newly developed surgical instruments, autologous dermal grafting is becoming an efficient, fast, and reproducible procedure with practically no complications. The cosmetic results reported here allow us to forsee wide applications for the Laser Dermal Implant™.

Upper and lower lip augmentation with dermal autografts

Increasing attention has been paid to the size, shape, and contour of the lips, resulting in more patients desiring aesthetic lip enhancement. Various implants and techniques have been described to augment thin and wrinkled lips. These have included allogenic injectable substances such as liquid silicone 1 and bovine collagen (Collagen Corp., Palo Alto, CA). 2 Other implantable substances, such as suture threading and Gore-tex (W.L. Gore, Flagstaff, AZ), 3'4 have also been used for lip augmentation. Autologous fat injection for lip augmentation has also been described. The major disadvantages of these substances have been related to graft resorption, lack of predictable augmentation, possible infection, graft rejection, and allergic reaction. Other procedures , including vermilion advancement by excision of white lip and various mucosal advancement techniques have also been described to create a more appealing lip. 56 Although these procedures do not involve implanting allogenic substances, each of them can result in an unnatural appearance of the lips. Any surgical procedure to enhance the appearance of the lips should create a natural lip appearance. Dermal-fat lip augmentat ion has the advantage of using autologous tissue that becomes incorporated at the recipient site from the rich vascular bed of the lips. The procedure allows implantation of grafts into small incisions on the vermilion surface of the lips. Because autologous tissue is used, the possibility for infection, allergic reaction, or graft rejection is minimal. This article describes the indications, technique, and potential complications of augmentat ion of the upper and lower lips with autologous dermal grafts.

An attempt to treat intractable skin ulcers with autologous dermal graft

Five patients with a total of seven chronic intractable skin ulcers and impaired peripheral blood circulation were treated with autologous dermal grafts which did not contain any epidermal component. These ulcers were refractory to conventional therapy. Results from the dermal grafting were variable, with four of the ulcers (in two patients) healing 1–8 months after 1–5 graftings. These findings suggest the possibility that dermal grafting may be a simple yet effective treatment for deep, super-infected skin ulcers in which tendons and bones have become exposed. Dermal grafting may also provide an additional method by which to treat chronic skin ulcers which do not respond to conventional surgical therapy and where amputation of affected extremities is being considered.

Evaluation of corpora alterations and erectile dysfunction following radical surgery for Peyronie's disease and long-term follow-up on 152 operated patients.

The radical surgical option we propose for Peyronie's disease consists in removing the sclerohyalinotic focus of disease and replacing it by an autologous dermal graft taken from the upper outer thigh area. Between 1981 and 1991, we operated on 335 patients with Peyronie's disease, 152 of whom underwent plaque excision and dermal graft. All could be assessed with a 2-year follow-up. Two main complications were observed: mild penile flexure due to scar retraction of the graft (35% of cases), and partial erectile deficit with decreased corporal rigidity (17% of cases). The degree of graft retraction is linked to the individual's histologic response. A mild deviation of the penis can occur some months after surgery and is not a relapse flexure due to disease progression, but is mere scar retraction and will spontaneously regress. Because the patient will date the onset of a postoperative erectile deficit from the time of the operation, it is advisable to assess preoperatively the erectile ability of all patients. Furthermore, an impaired erectile response could result from hypoaesthesia of the glans, postsurgical stress, and fibrosis of the erectile tissue. A retrospective assessment of radical surgery cases involving plaque excision and dermal graft led us to propose this option where precise indications apply, providing that other alterations of the erectile function are preoperatively assessed.