Diana Spallone

The use of MatriDerm® and skin grafting in post-traumatic wounds

The aim of this study was to prove the effectiveness of MatriDerm® combined with skin grafting versus skin grafting alone in post‐traumatic wounds treatment. At the Department of Plastic and Reconstructive Surgery of the University of Rome Tor Vergata, we treated 60 patients: 30 patients with dermal substitutes (MatriDerm®) combined with autologous skin graft and 30 with skin graft alone. Two weeks after the first treatment, 95% of wounds treated with MatriDerm® and skin graft showed a re‐epithelisation, whereas it was 75–80% in the control group. We used the Manchester Scar Scale (MSS) and patients self‐estimation scale to assess the outcomes. Mann–Whitney U test was performed for the five items of the MSS and the results were combined to those of patients self‐estimation scale and the re‐epithelialisation percentage to test the significance between the two groups. These data confirm the evidence of the clinical use of MatriDerm® technology in the healing of soft tissue wounds and prove the effectiveness of combining MatriDerm® and skin grafting for the first time. Furthermore, we observed a percentage reduction of wound contraction and in the same time an improvement of elasticity, quality of scars tissue and dermal architecture.

The use of Matriderm and autologous skin grafting in the treatment of diabetic ulcers: a case report.

The aim of our case report was to analyse the results obtained with the Matriderm® system and autologous skin grafting for the surgical treatment of diabetic ulcers. We recruited one patient with diabetic ulcers admitted at the Department of Plastic and Reconstructive Surgery, University of Rome ‘Tor Vergata’. The patient underwent Matriderm® system and autologous skin grafting for diabetic ulcer treatment. After just a single treatment, we obtained reduction in ulcer after 15 days from the surgical treatment. We achieved a reduction in pain and exudate secretion of the ulcer. We noticed an almost complete restoration of the missing volume and good quality of skin. Matriderm® system and autologous skin grafting is a simple, safe and feasible technique. This method, when compared with other methods of treatment, is simple, cheap, less time consuming and does not require sophisticated laboratory facilities.

Use of platelet-rich plasma and hyaluronic acid in the loss of substance with bone exposure

OBJECTIVE:In lower-extremity surgery, the complex wound with bone exposure remains a challenging problem for the plastic surgeon. The purpose of this study was to describe a new therapeutic approach to stimulate the regeneration of the lower-extremity complex wounds based on a combined treatment composed of platelet-rich plasma (PRP) and hyaluronic acid (HA) dressing. DESIGN:Wounds with posttraumatic bone exposure have been treated with HA dressing alone or in combination with PRP. PATIENT:Fifteen patients affected by lower-extremity wound with posttraumatic bone exposure have been treated at the Department of Plastic and Reconstructive Surgery, University of Tor Vergata, Rome, Italy. RESULTS:After a single treatment, the authors observed that the mean re-epithelialization time was 8.1 weeks in 73.3% patients treated with PRP and HA dressing versus the 30% patients treated with HA dressing only. CONCLUSION:These data confirm the evidence of using PRP technology in the healing of both soft- and hard-tissue wounds. Moreover, the satisfaction of the patient confirms the quality of this studys results.

Use of a novel autologous cell-harvesting device to promote epithelialization and enhance appropriate pigmentation in scar reconstruction

Background.  Epidermal replacement is an important step in the management of patients with post‐traumatic and iatrogenic scars. Skin‐colour variation from disease or trauma causes significant changes in self‐image and appearance.

Skin necrosis of scrotum due to endovascular embolisation: a case report

The aim of our case report was to analyse the results obtained with the Matriderm® system and autologous skin grafting for the surgical treatment of skin necrosis of scrotum as a result of endovascular embolisation. We recruited one patient with scrotum skin necrosis as a result of endovascular embolisation admitted at the department of Plastic and Reconstructive Surgery, University of Rome ‘Tor Vergata’. The patient underwent Matriderm® system and autologous skin grafting for skin necrosis treatment. After a single treatment, reduction of the skin necrosis was obtained, after 30 days from the surgical treatment. Patient experienced a reduction in pain and a complete restoration of the loss in volume and quality of skin was noticed. Matriderm® system and autologous skin grafting is a simple, safe and feasible technique. When comparing this treatment with others, Matriderm® is a simpler, more economic and less time‐consuming method, and does not require sophisticated laboratory facilities.

Reconstruction of the Skin in Posttraumatic Wounds

A wound is a breach of the skin that can lead to infection and sepsis. Fast wound closure and minimal scar contracture must be taken into account as primary end points. Wound healing is an evolutionarily conserved complex multicellular process that aims to restore a skin barrier and consists of four stages:

New Trends in Reconstructive Surgery : Report of a Young Woman With Extensive Sulfuric Acid Burns

We report a case of a female Pakistan patient aged 25 years with a 25% total body surface area third degree full-thickness burns caused by sulfuric acid. She has been a victim of domestic assault for marital discord. She has been admitted to the plastic surgical ward of Policlinico Casilino from September 2001 to November 2006. Sites of the burn injuries included: face, head, neck, upper limbs, and chest. The challenge was to save the eyes, the mouth, the nose, the neck and give back a “human” face to this young patient who also suffered severe social impairment. She required 17 reconstructive operations. The first of these was a Z-plasty on the neck and nostrils expansion. The second procedure consistedof skingraftingof theneckregionandunder thechin and a lateral naso-labial Z-plasty. The third procedure involved two steps: first, the collection of a full-thickness skin graft from a donor site of the right inguinal area, and V–Y plasty on the face (nostrils and columella). The fourth and the fifth procedures involved fullthickness skin graft under lower lip. The sixth procedure was an extra aural implant of the right ear with placement of three fixtures of 3-mm each. The seventh procedure involved lengthening of articular capsule of the right hand. The eighth and ninth procedures were performed to harvest full-thickness grafts (Wolfe Krause) from the right inguinal region. During the first one grafts were transplanted on both upper eyelid and the tarsorrhaphy was performed; in the second one the skin graft was placed on the neck. At the same time a nasolabial flap has been collected for the following reconstruction of the columella. During the 10th procedure, a commissuroplasty was performed using the collected flap (nasolabial) to recreate the natural appearance of the labial rim and to obtain projection of the columella. The 16th procedure involved the insertion and then, the removal of the skin expanders of the eyelid and neck followed by flap remodelling and a vermilion plasty. Last procedure was that of platelet gel application of the face. The purpose of the authors was functional and aesthetic rehabilitation which has been achieved in this patient with this plan of reconstruction.