title: Coverage of Deep Cutaneous Wounds Using Dermal Template in Combination with Negative-pressure Therapy and Subsequent Skin Graft.
abstract: BACKGROUND
  We consider the use of dermal matrix associated with a skin graft to cover deep wounds in the extremities when tendon and bone are exposed. The objective of this article was to evaluate the efficacy of covering acute deep wounds through the use of a dermal regeneration template (Integra) associated with vacuum therapy and subsequent skin grafting.
  
  
  METHODS
  Twenty patients were evaluated prospectively. All of them had acute (up to 3 weeks) deep wounds in the limbs. We consider a deep wound to be that with exposure of bone, tendon, or joint.
  
  
  RESULTS
  The average area of integration of the dermal regeneration template was 86.5%. There was complete integration of the skin graft over the dermal matrix in 14 patients (70%), partial integration in 5 patients (25%), and total loss in 1 case (5%). The wound has completely closed in 95% of patients.
  
  
  CONCLUSIONS
  The use of Integra dermal template associated with negative-pressure therapy and skin grafting showed an adequate rate of resolution of deep wounds with low morbidity.
authors.affiliation: Division of Plastic Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; and Division of General Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Dimas A
authors.initials: DA
authors.lastname: Milcheski
authors.affiliation: Division of Plastic Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; and Division of General Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Alexandre A
authors.initials: AA
authors.lastname: Chang
authors.affiliation: Division of Plastic Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; and Division of General Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Rodolfo C
authors.initials: RC
authors.lastname: Lobato
authors.affiliation: Division of Plastic Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; and Division of General Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Nakamoto
authors.affiliation: Division of Plastic Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; and Division of General Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Tuma
authors.affiliation: Division of Plastic Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; and Division of General Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Marcus C
authors.initials: MC
authors.lastname: Ferreira