title: Retrospective analysis of 56 soft tissue defects treated with one-stage reconstruction using dermal skin substitutes.
abstract: BACKGROUND
  The closure of wounds associated with soft tissue defects is surgically challenging, frequently requiring extensive plastic surgery and free flaps. The combination of dermal skin substitutes and split-thickness skin grafting is an innovative method used to cover such wounds. We incorporated this technique into the standard therapeutic armamentarium for complex injuries to the extremities. Clinical results of 56 patients thus treated are presented.
  
  
  METHODS
  In 44 (78.6 %) cases, the method described was used for defects on the lower extremities, including seven (12.5 %) individuals undergoing amputation stump coverage. Twelve (21.4 %) defects were located on the upper extremities. In two (3.6 %) cases, Matriderm(®) matrix was used to protect nerves from adjacent surgical implants.
  
  
  RESULTS
  In 41 (73.2 %) patients, the graft healed without any complication. Fifteen (26.8 %) patients displayed impaired wound healing following defect closure and were subsequently managed conservatively. One patient (1.8 %) showed graft failure, leading to revision surgery. None of the patients required extensive plastic surgery.
  
  
  CONCLUSIONS
  In cases where plastic surgery is unavailable or undesirable, the use of dermal skin substitutes in combination with split-thickness skin grafting represents a promising alternative for covering wounds associated with soft tissue defects.
authors.affiliation: Department of Trauma and Reconstructive Surgery, University Medicine Greifswald, Greifswald, Germany.|Department of Trauma and Orthopedic Surgery, Unfallkrankenhaus Berlin, Berlin, Germany.
authors.forename: Denis
authors.initials: D
authors.lastname: Gümbel
authors.affiliation: Department of Trauma and Orthopedic Surgery, Unfallkrankenhaus Berlin, Berlin, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Ackerl
authors.affiliation: Department of Trauma and Reconstructive Surgery, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Napp
authors.affiliation: Department of Dermatology, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Daeschlein
authors.affiliation: Department of Trauma and Orthopedic Surgery, Unfallkrankenhaus Berlin, Berlin, Germany.
authors.forename: Nikolai
authors.initials: N
authors.lastname: Spranger
authors.affiliation: Department of Urology, Research Laboratory, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Matthias B
authors.initials: MB
authors.lastname: Stope
authors.affiliation: Department of Trauma and Reconstructive Surgery, University Medicine Greifswald, Greifswald, Germany.|Department of Trauma and Orthopedic Surgery, Unfallkrankenhaus Berlin, Berlin, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Ekkernkamp
authors.affiliation: Department of Trauma and Reconstructive Surgery, University Medicine Greifswald, Greifswald, Germany.|Department of Trauma and Orthopedic Surgery, Unfallkrankenhaus Berlin, Berlin, Germany.
authors.forename: Gerrit
authors.initials: G
authors.lastname: Matthes
mesh_terms: D006801:Humans; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D016038:Skin Transplantation; D017768:Skin, Artificial; D017695:Soft Tissue Injuries