title: Compared to coverage by STSG grafts only reconstruction by the dermal substitute Integra® plus STSG increases TcPO2 values in diabetic feet at 3 and 6 months after reconstruction*.
abstract: OBJECTIVE
  Purpose of this retrospective comparative study is to evaluate the results of reconstruction of diabetic feet by split thickness skin graft (STSG) and by dermal substitute Integra® covered by STSG in terms of vascularity of the reconstructed wound-bed by measurements of tissue oxygenation (TcPO2).
  
  
  METHODS
  23 patients were included into the study (12 were reconstructed by STSG only and 11 with Integra® and STSG three weeks later). In each patient TcPO2 measurements were performed at the same spot of the reconstructed area at 14 days, one month, 3 months, 6 months, 12 months and 24 months after reconstruction.
  
  
  RESULTS
  Wound beds reconstructed by Integra® showed on average 10 mmHg higher TcPO2.
  
  
  CONCLUSIONS
  Our study estimated in an objective way, by TcPO2 value measurements, the oxygenation of the wound bed in diabetic feet after reconstruction by STSG only and after adding dermal substitute Integra® to the wound bed before final STSG coverage. During first month after reconstruction no statistically significant differences were found. After 3 months TcPO2 studies revealed statistically significant higher oxygen tissue pressure in diabetic feet covered by Integra® plus STSG. These findings endorse in an objective way the clinical findings already reported while using the dermal substitute. It remains to explain the role of this increase of oxygen tissue pressure in redefine the indications for the use of dermal substitutes in reconstruction of poor vascularized regions.
authors: G
authors: G
authors: Papa
authors: L
authors: L
authors: Spazzapan
authors: M
authors: M
authors: Pangos
authors: A
authors: A
authors: Delpin
authors: Z M
authors: ZM
authors: Arnez
mesh_terms: D000368:Aged; D001785:Blood Gas Monitoring, Transcutaneous; D002809:Chondroitin Sulfates / Q000627:therapeutic use*; D003094:Collagen / Q000627:therapeutic use*; D017719:Diabetic Foot / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: C114835:integra artificial skin; D002809:Chondroitin Sulfates; D003094:Collagen