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العنوان
Evaluation of the use of Single Stage
Dermal Substitutes in acute and
chronic wounds of the Hand /
المؤلف
Mohamed,Ahmed Awad Mitwalli.
هيئة الاعداد
باحث / Ahmed Awad Mitwalli Mohamed
مشرف / Ahmed Mohamed Salah El-din El-badawy
مشرف / Ahmed Ali Hassan
مشرف / Nada Abdel Sattar Mahmoud
تاريخ النشر
2018
عدد الصفحات
151p.:
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
الطب البديل والتكميلي
تاريخ الإجازة
1/1/2018
مكان الإجازة
جامعة عين شمس - كلية الطب - جراحة التجميل والحروق والوجه والفكين
الفهرس
Only 14 pages are availabe for public view

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Abstract

ADM materials are a potentially important tool for the
burn surgeon in the acute and reconstructive setting. Many
favorable reports have been published, but they are generally
characterized by small sample sizes, limited objective testing,
and retrospective analysis. There does appear to be some
evidence for ADM application in patient populations in whom
donor site availability (those with massive burns) or morbidity
(children, the elderly) is a concern, but this has not been
rigorously evaluated.
Controlled prospective trials are necessary, particularly
in the reconstructive arena, to identify optimization of ADM
placement. Perhaps identification of manipulations that can
facilitate revascularization (permitting use of even thicker
materials) or the availability of more cost-effective xenogenic
options will herald an even greater routine adoption of ADM
in the management of the burn patient.
Stressing the importance of the dermis in long-term
durability and success rates, a number of investigators have
evaluated a variety of materials as dermal substitutes or
scaffolds on which a useful favorable neodermis is formed.
These include products such as Integra (Integra Life Sciences
Corp., Plainsboro, New Jersey), Matriderm (De Suwelack Skin and Health Care AG, Billerbeck, Germany), and others.
Integra was one of the original ―dermal regeneration
templates,‖ and this material has had success in settings both
acute and reconstructive. However, this bilayer construct
requires a two-stage approach, separated by two to four
weeks. The newer product, Matriderm, has demonstrated
successful take, favorable histologic findings, and improved
scarring when applied in acute and reconstructive burn
patients, compared to conventional grafting. Matriderm
investigators were successful in achieving a one- stage
application of dermal substitute and skin graft, and the
reconstructive patients had improved elasticity in the short
term. A recent 11-year follow-up revealed improved
subjective scar assessment measurements and elasticity in
the substituted group.
Further description of these constructs is beyond the
scope of this article, but they have received considerable
application in acute burns and reconstructive surgery and
are a valuable option for the burn surgeon.