title: Comparative Skin Evaluation After Split-Thickness Skin Grafts Using 2 Different Acellular Dermal Matrices to Cover Composite Forearm Defects.
abstract: OBJECTIVE
  The combination of acellular dermal matrix (ADM) and split-thickness skin graft (STSG) has been widely adopted to overcome functional and cosmetic limitations of conventional STSG. In this study, we evaluated the efficacy of this combination using 2 types of ADM: cadaveric acellular dermal matrix (CDM) and bovine acellular dermal matrix (BDM).
  
  
  METHODS
  We recruited 72 patients undergoing autologous STSG to cover radial forearm free flap donor sites. They were included in 1 of 3 therapeutic groups: group 1, STSG using CDM (n = 29); group 2, STSG using BDM (n = 20); and group 3, STSG only (n = 23). Functional skin values for skin elasticity, humidification, transepidermal water loss, and color were determined. Values were compared between graft sites and adjacent normal (control) skin, and between grafted areas of each group.
  
  
  RESULTS
  All skin defects were successfully reconstructed without graft loss. Groups 1 and 2 demonstrated better elasticity than did group 3, based on the analysis using the ratio of grafted area to control. Grafted areas in all 3 groups exhibited less moisture than did control normal skin. There was less transepidermal water loss in group 1 than in group 3, which implied that CDM application had better barrier capacity against water evaporation. Graft sites of groups 1 and 3 exhibited darker and redder color compared with control areas.
  
  
  CONCLUSIONS
  Composite forearm defects were successfully restored and exhibited acceptable quality after treatment with an ADM plus STSG. Applying either CDM or BDM under a STSG was a suitable procedure, as verified by objective measurements. Elasticity was well preserved in CDM and BDM groups. However, both ADMs revealed functional impairment of humidification.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Seoul, Korea; Department of Medicine, Yonsei University Graduate School of Medicine, Seoul, Korea.
authors.forename: Myung Chul
authors.initials: MC
authors.lastname: Lee
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yong Jun
authors.initials: YJ
authors.lastname: Jang
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: In Sik
authors.initials: IS
authors.lastname: Yun
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Dae Hyun
authors.initials: DH
authors.lastname: Lew
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Korea. Electronic address: pswjlee@yuhs.ac.
authors.forename: Won Jai
authors.initials: WJ
authors.lastname: Lee
mesh_terms: D062088:Acellular Dermis; D000328:Adult; D000368:Aged; D000818:Animals; D002102:Cadaver; D002417:Cattle; D062109:Dermatologic Surgical Procedures; D005260:Female; D005542:Forearm / Q000601:surgery*; D005543:Forearm Injuries / Q000209:etiology / Q000601:surgery*; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012867:Skin; D016038:Skin Transplantation / Q000379:methods*; D017768:Skin, Artificial; D013524:Surgical Flaps; D014182:Transplantation, Autologous; D014945:Wound Healing; D014947:Wounds and Injuries / Q000209:etiology / Q000601:surgery*
keywords: Acellular dermal matrix; functional skin value; radial forearm flap donor site