title: Long-term patient-reported functional and cosmetic outcomes following severe traumatic foot and ankle wound reconstruction with acellular dermal matrix.
abstract: BACKGROUND
  The prevalence of acellular dermal matrices in reconstructive surgery has increased through the last decade with satisfying outcomes. Long-term follow-up and effectiveness studies could enable appropriate use of these devices and challenge the current gold-standard treatments. This paper presents functional and cosmetic long-term outcomes on the Integra(®) Dermal Regeneration Template (IDRT) for treating traumatic soft-tissue defects of the foot and ankle.
  
  
  METHODS
  All adult patients who underwent severe traumatic foot and ankle reconstruction with Integra(®) since 2004 were retrospectively included. Results were evaluated using standardized outcome instruments.
  
  
  RESULTS
  Twenty-one reconstructions were evaluated 4.5 ± 2.5 years after foot and ankle injury. Major complications inducing a second application included 1 hematoma and 1 infection. Seven patients (35%) had good or excellent Foot and Ankle Ability Measures. Subjectively, when asked to compare current function with pre-injury status, the mean response was 66 ± 23%. The Observer Scar Assessment Scale scored 17 ± 5 points (possible range, 5-50), while the Patient Scar Assessment Scale scored 30 ± 11 points (possible range, 6-60).
  
  
  CONCLUSIONS
  Long-term functional and cosmetic outcomes 4.5 years after severe traumatic foot and ankle wounds treated with IDRTs were rated fair in the great majority of patients. Nevertheless, because complications and surgical revisions were few, potential benefits might be underestimated because of the initial combined injuries and their sequelae. In this way, for appropriately selected patients with severe traumatic foot and ankle soft-tissue defects, including subacute coverage, it appears that this treatment may be a viable first option.
authors: a Plastic Surgery and Burns Unit, Centre FX Michelet, Bordeaux University Hospital , Bordeaux , France.
authors: Romain
authors: R
authors: Weigert
authors: a Plastic Surgery and Burns Unit, Centre FX Michelet, Bordeaux University Hospital , Bordeaux , France.
authors: Franck Marie
authors: FM
authors: Leclere
authors: b Division of Plastic Surgery, Messina University , Messina , Italy.
authors: Gabriele
authors: G
authors: Delia
authors: c Burns Unit, Armand Trousseau Children Hospital, Paris 6 University , Paris , France.
authors: Laura
authors: L
authors: De Luca
authors: a Plastic Surgery and Burns Unit, Centre FX Michelet, Bordeaux University Hospital , Bordeaux , France.
authors: Khalid
authors: K
authors: Al Mutairi
authors: a Plastic Surgery and Burns Unit, Centre FX Michelet, Bordeaux University Hospital , Bordeaux , France.
authors: Vincent
authors: V
authors: Casoli
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000601:surgery*; D002809:Chondroitin Sulfates; D002921:Cicatrix / Q000209:etiology / Q000523:psychology; D003094:Collagen; D004954:Esthetics; D005260:Female; D018409:Foot Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D017768:Skin, Artificial; D017695:Soft Tissue Injuries / Q000601:surgery*
chemical_list: C114835:integra artificial skin; D002809:Chondroitin Sulfates; D003094:Collagen
keywords: acellular dermal matrix; ankle; foot; integra; outcomes; traumatic wound