Use Of Dermal Regeneration Template Research Articles

Dermal Regeneration Template in the Management and Reconstruction of Burn Injuries and Complex Wounds: A Review.

Dermal scaffolds have created a paradigm shift for burn and wound management by providing improved healing and less scarring, while improving cosmesis and functionality. Dermal regeneration template (DRT) is a bilayer membrane for dermal regeneration developed by Yannas and Burke in the 1980s. The aim of this review is to summarize clinical evidence for dermal scaffolds focusing on DRT for the management and reconstruction of burn injuries and complex wounds. A comprehensive search of PubMed was performed from the start of indexing through November 2022. Articles reporting on DRT use in patients with burns, limb salvage, and wound reconstruction were included with focus on high-level clinical evidence. DRT has become an established alternative option for the treatment of full-thickness and deep partial-thickness burns, with improved outcomes in areas where cosmesis and functionality are important. In the management of diabetic foot ulcers, use of DRT is associated with high rates of complete wound healing with a low risk of adverse outcomes. DRT has been successfully used in traumatic and surgical wounds, showing particular benefit in deep wounds and in the reconstruction of numerous anatomical sites. Considerable clinical experience has accrued with the use of DRT beyond its original application for thermal injury. A growing body of evidence from clinical studies reports the successful use of DRT to improve clinical outcomes and quality of life across clinical indications at a number of anatomical sites.

Comment on "The use of dermal regeneration template (Pelnac®) in a complex upper limb trauma: the first Italian case report".

Comment on "The use of dermal regeneration template (Pelnac®) in a complex upper limb trauma: the first Italian case report".

Technical refinements in the use of dermal regeneration template in full thickness scalp defects after radical cancer surgery

Technical refinements in the use of dermal regeneration template in full thickness scalp defects after radical cancer surgery

Coverage of Hand Defects with Exposed Tendons: The Use of Dermal Regeneration Template.

Soft tissue defects associated with exposed tendon pose difficult reconstructive problems because of tendon adhesions, poor range of motion, poor cosmetic appearance, and donor site morbidity. Dermal regeneration template is a skin substitute widely used in reconstructive surgery, including the occasional coverage of tendons. However, postoperative functionality of the tendons has not been well documented. We report a case of using dermal regeneration template for soft tissue reconstruction overlying tendons with loss of paratenon in a patient with Dupuytren's contracture. Dermal regeneration template may offer an alternative option for immediate tendon coverage in the hand.

Dermal Regenerative Template as a Cost-Effective Alternative for Complex Scalp Reconstruction.

Use of dermal regeneration template (DRT) is well documented in the literature for complex wounds ranging from the scalp, trunk, and lower extremity. A retrospective cohort study was performed of the use of dermal regeneration template and skin grafting. A literature review was performed of all studies where DRT was used for scalp reconstruction. Patients in the DRT cohort had an average age of 70, with wounds averaging 108 cm in size. These patients also had a relatively low rate of complications (0.4), a short hospital stay (average 2 days), and a relatively short operating room time (114 minutes). This study demonstrates dermal regeneration template to be an effective and reliable option for soft tissue reconstruction with minimal morbidity and complications in patients with extensive medical comorbidities. Emerging applications include radiation exposure and hypercoaguable states.

The use of dermal regeneration template (Pelnac®) in acute full-thickness wound closure: A case series

Dermal regeneration template (DRT) has been well implicated in the reconstruction of full-thickness burn injury. This case series specifically presents our experience and our clinical application of Pelnac® to achieve wound closure with complex acute full-thickness defect. A retrospective review of patients treated with Pelnac for complex wound defects from 2008 to 2014 at Concord Burns Unit was carried out. Variables such as wound aetiology, wound size and complications were considered. Five patients (four females and one male with a mean age 54 ± 20) all had full-thickness defects (mean defect size 4.3 ± 2.0 % TBSA), some with exposed tendon and bone. The wounds were treated with Pelnac®; the silicone layer was removed at postoperative day 14 and a split-thickness skin graft (0.2 to 0.3 mm) was applied. Clinically, the reconstructed areas demonstrated good granulation tissue at 14 days with good take of the skin graft. There were no major acute graft loss, rejection or associated infection. However, there were small areas of graft loss which did not require re-grafting. DRT provides a safe and efficacious alternative when dealing with acute contaminated full-thickness wounds. Pelnac® seems versatile in obtaining wound coverage in difficult complex wounds, especially in critically ill patients where free or pedicle flap reconstruction would be problematic. Level of Evidence: Level V, therapeutic study.

One-Stage Reconstruction of Scalp after Full-Thickness Oncologic Defects Using a Dermal Regeneration Template (Integra).

The use of Dermal Regeneration Template (DRT) can be a valid alternative for scalp reconstruction, especially in elderly patients where a rapid procedure with an acceptable aesthetic and reliable functional outcome is required. We reviewed the surgical outcome of 20 patients, 14 (70%) males and 6 (30%) females, who underwent application of DRT for scalp reconstruction for small defects (group A: mean defect size of 12.51 cm2) and for large defects (group B: mean defect size of 28.7 cm2) after wide excision of scalp neoplasm (basal cell carcinoma and squamous cell carcinoma). In group A, the excisions were performed to the galeal layer avoiding pericranium, and in group B the excisions were performed including pericranium layer with subsequent coverage of the exposed bone with local pericranial flap. In both the groups (A and B) after the excision of the tumor, the wound bed was covered with Dermal Regeneration Template. In 3 weeks we observed the complete healing of the wound bed by secondary intention with acceptable cosmetic results and stable scars. Scalp reconstruction using a DRT is a valid coverage technique for minor and major scalp defects and it can be conducted with good results in elderly patients with multiple comorbidities.

Template for Skin Regeneration

Advances in critical care allowed survival of large total body surface burn patients in the 1970s, spawning the development of artificial skin for burn victims. Lack of dermis resulted in severe scarring and contractures. The physicochemical properties that are critical to dermal regeneration have subsequently been described, and a dermal regeneration template has been developed. The peer-reviewed literature regarding the basic science and clinical use of dermal regeneration template was reviewed, as was our practical experience in using dermal regeneration template. Dermal regeneration template has been effective in treating large areas of skin loss in burn victims and has been shown to have scar reductive and regenerative properties. Its use has been extended to reconstructive burns, including scar revisions and the treatment of burn scar contractures. It has also been useful in treating small areas of exposed bone, tendon, or joints and a variety of acute and chronic wounds. Meticulous wound bed preparation and close monitoring of the dermal regeneration template is critical to successful use. Dermal regeneration template provides a novel element to add to the reconstructive tools used today by plastic surgeons. Further development of these technologies may allow for improved regenerative capacity of these devices to allow optimal aesthetic and functional results of dermal reconstruction.

Use of Dermal Regeneration Template (Integra) for Reconstruction of Full-Thickness Complex Oncologic Scalp Defects

The reconstruction of full-thickness scalp defects remains a surgical challenge. Different types of reconstruction had varying success including the use of dermal regeneration template (DRT). We reviewed the surgical outcome of 30 patients who underwent application of DRT for resurfacing of full-thickness scalp defects when the pericranium was excised and the outer cortex of the calvarial bone was burred after the excision of scalp neoplasm. This was a retrospective review of 30 patients who had scalp reconstruction with DRT undertaken by the senior author between October 2004 and June 2007. The mean age of patients in our series was 63 years (37-91 years). There were 14 men and 16 women. The indications for re-excision and DRT reconstruction in 28 patients were close margins and aggressive tumor type, whereas 2 patients had a recurrence. The mean defect size was 95 cm2 (16-275 cm2). The second stage of the reconstruction occurred on postoperative day 42 (postoperative days 27-62). The mean follow-up period was 14 months. Two patients had minor complications. For both stages, the combined average operative time was 128 minutes. The use of DRT is a rung of the reconstructive ladder that deserves consideration. In our series of 30 patients who required secondary reconstruction of complex scalp defects, the use of DRT has been seen to provide safe and durable soft-tissue cover for full-thickness scalp defects. The reduced operative time and inpatient stay are desirable characteristics particularly in elderly patients with multiple comorbidities.

The use of Dermal Regeneration Template (Integra ®) for reconstruction of a large full-thickness scalp and calvarial defect with exposed dura

The reconstruction of large full-thickness scalp defects remains a challenge, particularly when dura is exposed. Various reconstructive methods have been described in the past. Dermal Regeneration Templates (DRTs) are becoming increasingly popular in the management of acute wounds as well as the reconstruction of burn scars, oncological defects and various other complex reconstructive problems. We describe a case where Integra® was successfully used together with a Vacuum-Assisted Closure (VAC) dressing to reconstruct a full-thickness scalp defect with exposed dura. Surgical technique is discussed as well as problems encountered during the case and possible solutions.

The surgical challenge of giant circumferential congenital naevi of the extremities: a 13-year follow-up of two cases

The surgical management of giant congenital melanocytic naevi involving extremities in a circumferential pattern may represent a surgical challenge with respect to their resection and subsequent reconstructive options. We present our experience in the management of circumferential giant congenital melanocytic naevi involving the upper limb in one patient and lower limb in another one. They were managed and followed up for 13 years. The lesion regenerated following dermabrasion in the first patient and regenerated following tangential excision and split-thickness skin graft in both patients. Therefore, another approach was used, full-thickness resection of the lesions and reconstruction with dermal regeneration template (Integra™), followed by ultrathin split-thickness skin graft. The last approach resulted in no recurrence during a 3-year follow-up. The complexity of these lesions and the limitation of different surgical approaches have been highlighted. Full-thickness excision of the affected integument and the use of dermal regeneration template is a useful technique which can be considered in the management of circumferential giant melanocytic naevi, particularly when other established methods have failed to provide satisfactory results.

Severe Multiple Extensive Postburn Contractures: A Simultaneous Approach With Total Scar Tissue Excision and Resurfacing With Dermal Regeneration Template

Deep partial or full-thickness burns if untreated, neglected, or managed conservatively can develop dysfunctional scar contractures with severe deformities and significant reduction in patient's activities of daily life. These burn sequelae can require multistage procedures to restore anatomy and function. These include single scar release, use of skin grafts, skin expansion, regional or free musculocutaneous or fasciocutaneous flaps to achieve adequate functional improvement. The use of dermal regeneration template (Integra), initially used in primary burns reconstruction, has been already described and compared in single scar contracture-releasing procedures, but to our knowledge, it has not been used in the simultaneous releasing of multiple severe extensive postburn contractures. A simultaneous approach with total scar tissue excision and resurfacing with Integra may reduce the number of operations and the prolonged time period of treatment required by conventional procedures of multistage scar contracture release. A 7-year-old girl, who developed severe postburn scar contractures involving the right upper limb, right axilla, neck, and face after healing of a deep 16% total body surface area burn injury, was treated with this approach. Restoration of anatomy and function, with significant improvement in the range of movement of the involved regions, was achieved in a relatively short period of time (15 weeks) with limited donor-site morbidity and preservation of donor areas for possible future procedures. Total scar tissue excision and resurfacing with Integra should be considered as a valid option in case of simultaneous management of severe multiple extensive scar contractures.

The use of dermal regeneration template in the treatment of burns in children

The use of dermal regeneration template in the treatment of burns in children

The use of dermal regeneration template in the treatment of burns in children

The use of dermal regeneration template in the treatment of burns in children

The Clinical and Histological Results of the Use of Dermal Regeneration Template in Reconstructive Surgery

The Clinical and Histological Results of the Use of Dermal Regeneration Template in Reconstructive Surgery