Closing the gap: Healing acute complex wounds using an acellular dermal substitute - a prospective case series.

Abstract

Although various dermal substitutes are available, their use in the acute setting or for extensive surface areas is often constrained by high costs and labor-intensive application procedures. Despite these challenges, they have proven effective in treating different skin and soft tissue defects. In this prospective case series, 26 adults with acute complex deep soft tissue defects resulting from different etiologies were treated with Glyaderm. Glyaderm is a low-cost acellular dermal substitute and can be applied in either a one- or two-stage procedure with a split skin graft for epidermal coverage. Primary outcomes were graft take in percentage of the total covered wound area and time to complete wound closure. In total, 25 patients with an average age of 55.9 years completed the follow-up period. Etiologies of the acute complex wounds consisted of defects after oncological surgery (28%), debridement of soft tissue infections (28%), trauma (24%), donor site defects after free flap reconstruction (16%), and other (4%). Mean affected Total Body Surface Area was 2.2%, the mean size was 203 cm². At 5 to 7 days post-application, the mean graft take rate was 89.7%. The average time for wound closure was 30 days. A complication occurred in 16% of cases: three patients developed wound infection resulting in incomplete graft loss, while one patient experienced complete graft loss without an identifiable cause. All cases were regrafted using Glyaderm and subsequently healed without complications. Glyaderm appears to be a valid and effective reconstructive option for acute complex wounds.