title: One-stage Reconstruction of Soft Tissue Defects with the Sandwich Technique: Collagen-elastin Dermal Template and Skin Grafts.
abstract: BACKGROUND
  A full-thickness soft tissue defect closure often needs complex procedures. The use of dermal templates can be helpful in improving the outcome.
  
  
  OBJECTIVE
  The objective was to evaluate a sandwich technique combining the dermal collagen-elastin matrix with skin grafts in a one-stage procedure.
  
  
  METHODS
  Twenty-three patients with 27 wounds were enrolled in this prospective single-centre observational study. The mean age was 74.8 ± 17.2 years. Included were full-thickness defects with exposed bone, cartilage and/ or tendons. The dermal collagen-elastin matrix was applied onto the wound bed accomplished by skin transplants, i.e. 'sandwich' transplantation. In six wounds, the transplants were treated with intermittent negative pressure therapy.
  
  
  RESULTS
  The size of defects was ≤875 cm(2). The use of the dermal template resulted in a complete and stable granulation in 100% of wounds. Seventeen defects showed a complete closure and 19 achieved a complete granulation with an incomplete closure. There was a marked pain relief. No adverse events were noted due to the dermal template usage.
  
  
  CONCLUSIONS
  Sandwich transplantation with the collagen-elastin matrix is a useful tool when dealing with full-thickness soft tissue defects with exposed bone, cartilage or tendons.
authors.affiliation: Departments of Dermatology and Allergology, Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Wollina