title: Use of a Dermal Regeneration Template Wound Dressing in the Treatment of Combat-Related Upper Extremity Soft Tissue Injuries.
abstract: OBJECTIVE
  To assess the outcomes of treatment with a dermal regeneration template (DRT) in a cohort of combat casualties with severe upper extremity injuries.
  
  
  METHODS
  Records of all active duty military patients treated with DRT at our institution between November 2009 and July 2013 were screened. Inclusion criteria were upper extremity open wounds sustained during combat, requiring split-thickness or full-thickness skin grafting for closure. The primary outcome measure was wound healing after the first attempt at definitive treatment (defined as the first application of split-thickness or full-thickness skin graft). Independent variables collected included time from injury to arrival at our facility, mechanism of injury, wound infection, tobacco use, location of wound, number of operative debridements, and patient demographics.
  
  
  RESULTS
  A total of 60 patients with 69 wounds met the inclusion criteria. Most wounds were to the wrist or forearm (54%) or fingers (19%). All wounds were heavily contaminated, requiring a mean of 2.5 operative debridements before DRT placement. All wounds treated with full-thickness skin grafting after DRT healed completely without further complication. Split-thickness skin grafting was successful in 96% of patients.
  
  
  CONCLUSIONS
  DRT wound dressings are a helpful adjunct in the treatment of contaminated war wounds to the upper extremity.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Departments of Plastic, Orthopedic, and General Surgery, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Ian L
authors.initials: IL
authors.lastname: Valerio
authors.affiliation: Department of General Surgery, Keesler Medical Center, Biloxi, MS.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Masters
authors.affiliation: Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD.
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Seavey
authors.affiliation: Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD.
authors.forename: George C
authors.initials: GC
authors.lastname: Balazs
authors.affiliation: Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD.
authors.forename: Derek
authors.initials: D
authors.lastname: Ipsen
authors.affiliation: Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD; Department of Orthopaedic Surgery, University of Pennsylvania Health System, Philadelphia, PA. Electronic address: scott.tintle@gmail.com.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Tintle
mesh_terms: D000328:Adult; D001134:Arm Injuries / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D010147:Pain Measurement; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016038:Skin Transplantation / Q000379:methods*; D017768:Skin, Artificial; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D014857:Warfare; D014945:Wound Healing / Q000502:physiology*; D055815:Young Adult
keywords: Combat injury; Integra; dermal substitute