Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss
Summary:. Restoring function after traumatic defects of the palm is a reconstructive challenge, considering the need for flexible, elastic, and resistant skin. Dermal skin substitutes are biologically engineered materials composed of collagen and glycosaminoglycan, devoid of cellular structures. The...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2019-11-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002551 |
| _version_ | 1818067099197636608 |
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| author | Dominique Lucas, MD Damien Di Rocco, MD Camillo T. Müller, MD Abdo R. Jurjus, PhD Wassim Raffoul, MD Pietro G. di Summa, MD, PhD William Watfa, MD |
| author_facet | Dominique Lucas, MD Damien Di Rocco, MD Camillo T. Müller, MD Abdo R. Jurjus, PhD Wassim Raffoul, MD Pietro G. di Summa, MD, PhD William Watfa, MD |
| author_sort | Dominique Lucas, MD |
| collection | DOAJ |
| description | Summary:. Restoring function after traumatic defects of the palm is a reconstructive challenge, considering the need for flexible, elastic, and resistant skin. Dermal skin substitutes are biologically engineered materials composed of collagen and glycosaminoglycan, devoid of cellular structures. These biodegradable materials act as artificial dermis and stimulate neovascularization: they have been used for many years, mainly on the dorsal side of the hand and fingers, whereas the palmar side of the hand has been generally addressed by local flaps. In this study, we described our experience with dermal skin substitutes in two cases of palmar defects associated with exposed tendinous structures. Coverage of palmar defects in hand and fingers with dermal substitute and split thickness skin graft was performed on two patients. Both patients presented palmar-only loss of tissue (traumatic palmar amputation in the first patient and degloving-type injury in the second patient). Range of motion, functional outcomes, and satisfaction and aesthetical results were evaluated. The resulting skin showed good quality, thickness, pliability, and Disabilities of the Arm, Shoulder, and Hand (DASH) score. Additionally, the patients regained full range of motion and reported high satisfaction. The association of split thickness skin graft with dermal substitutes in palmar traumatic hand showed optimal functional and aesthetic outcomes. Although being more adapted to dorsal loss of substance, collagen-based dermal substitutes can also be useful reconstructive tools in palmar defects with exposed structures and could be used to a larger extent in the future. |
| first_indexed | 2024-12-10T15:18:17Z |
| format | Article |
| id | doaj.art-cd1e810a6db44a6fa7f17366f4007b13 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-10T15:18:17Z |
| publishDate | 2019-11-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-cd1e810a6db44a6fa7f17366f4007b132022-12-22T01:43:45ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742019-11-01711e255110.1097/GOX.0000000000002551201911000-00030Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue LossDominique Lucas, MD0Damien Di Rocco, MD1Camillo T. Müller, MD2Abdo R. Jurjus, PhD3Wassim Raffoul, MD4Pietro G. di Summa, MD, PhD5William Watfa, MD6From the *Plastic and Reconstructive Surgery Department, Centre Hospitalier Universitaire Vaudois, Lausanne, SwitzerlandFrom the *Plastic and Reconstructive Surgery Department, Centre Hospitalier Universitaire Vaudois, Lausanne, SwitzerlandFrom the *Plastic and Reconstructive Surgery Department, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland†Department of Anatomy, Cell Biology and Physiology, American University of Beirut, Beirut, LebanonFrom the *Plastic and Reconstructive Surgery Department, Centre Hospitalier Universitaire Vaudois, Lausanne, SwitzerlandFrom the *Plastic and Reconstructive Surgery Department, Centre Hospitalier Universitaire Vaudois, Lausanne, SwitzerlandFrom the *Plastic and Reconstructive Surgery Department, Centre Hospitalier Universitaire Vaudois, Lausanne, SwitzerlandSummary:. Restoring function after traumatic defects of the palm is a reconstructive challenge, considering the need for flexible, elastic, and resistant skin. Dermal skin substitutes are biologically engineered materials composed of collagen and glycosaminoglycan, devoid of cellular structures. These biodegradable materials act as artificial dermis and stimulate neovascularization: they have been used for many years, mainly on the dorsal side of the hand and fingers, whereas the palmar side of the hand has been generally addressed by local flaps. In this study, we described our experience with dermal skin substitutes in two cases of palmar defects associated with exposed tendinous structures. Coverage of palmar defects in hand and fingers with dermal substitute and split thickness skin graft was performed on two patients. Both patients presented palmar-only loss of tissue (traumatic palmar amputation in the first patient and degloving-type injury in the second patient). Range of motion, functional outcomes, and satisfaction and aesthetical results were evaluated. The resulting skin showed good quality, thickness, pliability, and Disabilities of the Arm, Shoulder, and Hand (DASH) score. Additionally, the patients regained full range of motion and reported high satisfaction. The association of split thickness skin graft with dermal substitutes in palmar traumatic hand showed optimal functional and aesthetic outcomes. Although being more adapted to dorsal loss of substance, collagen-based dermal substitutes can also be useful reconstructive tools in palmar defects with exposed structures and could be used to a larger extent in the future.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002551 |
| spellingShingle | Dominique Lucas, MD Damien Di Rocco, MD Camillo T. Müller, MD Abdo R. Jurjus, PhD Wassim Raffoul, MD Pietro G. di Summa, MD, PhD William Watfa, MD Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss Plastic and Reconstructive Surgery, Global Open |
| title | Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss |
| title_full | Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss |
| title_fullStr | Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss |
| title_full_unstemmed | Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss |
| title_short | Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss |
| title_sort | application of dermal skin substitutes for hand and finger palmar soft tissue loss |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002551 |
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