title: Use of a living dermal equivalent for a refractory abdominal defect after pediatric multivisceral transplantation.
abstract: BACKGROUND
  Primary closure is not always possible after pediatric multivisceral transplantation. Reepithelialization may require extended periods of postoperative time, which can be associated with significant morbidity.
  
  
  OBJECTIVE
  The objective was to accelerate secondary wound closure thereby minimizing infection or further complications in a pediatric multivisceral transplant patient.
  
  
  METHODS
  Five applications of human fibroblast-derived dermis (Dermagraft, Smith and Nephew) were applied to the postsurgical defect of a pediatric multivisceral transplant patient over the course of 8 months. Routine wound care and observation was performed between human fibroblast-derived dermis applications.
  
  
  RESULTS
  Human fibroblast-derived dermis stimulated healing and accelerated reepithelialization. Signs of clinical rejection or infection were not observed.
  
  
  CONCLUSIONS
  Reepithelialization can be aided in the postoperative period in pediatric multivisceral transplant patients with human fibroblast-derived dermis, thereby helping to deter complications associated with secondary wound closure. We have illustrated the successful use of a human fibroblast-derived dermis as an adjunct for wound healing in a complicated surgical defect.
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Florida 33125, USA.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Charles
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kato
authors.forename: Andreas G
authors.initials: AG
authors.lastname: Tzakis
authors.forename: Barbara N
authors.initials: BN
authors.lastname: Miller
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kirsner
mesh_terms: D000005:Abdomen / Q000601:surgery*; D046508:Culture Techniques; D005260:Female; D005347:Fibroblasts; D006801:Humans; D007223:Infant; D007421:Intestine, Small / Q000637:transplantation*; D016031:Liver Transplantation; D016038:Skin Transplantation / Q000379:methods*; D014945:Wound Healing