One-stage reconstruction of neck burns with single-layer dermal matrix

Abstract

Aim: The aim of the study was to describe the applicability of a single-layer acellular dermal matrix, in combination with split-thickness skin graft (STSG) in one-stage surgical procedure in patients with deep neck second - and third - degree burns.

Methods: A descriptive longitudinal study was conducted at the Burn Unit of the Health Services Unit of Simón Bolívar North Subnetwork E.S.E. of the Secretariat of Health in Bogotá, Colombia, from January 1 2016 to December 31 2017 in which we describe the applicability of a single-layer acellular dermal matrix in combination with STSG in one-stage surgical procedure in patients with deep neck second and third degree burns.

Results: A total of 9 patients were treated. Exposed areas required definitive coverage using a single-layer dermal regeneration matrix and autografts in a one-stage procedure, following excision of keloid scars and scar retractions (n = 7), and in the case of acute-phase deep burn wounds, following complete necrotic tissue removal (n = 2). No patient presented infection during postoperative follow-up. At 2 months postoperatively, stability of treated area and adequate resistance of the skin substitute and autografts could be observed. They appeared normal in color, with no degree of contractures or functional limitations.

Conclusion: This is the first study demonstrating that the use of a single-layer acellular dermal matrix template for one stage reconstruction of post-burn full thickness neck defects is an effective, safe and excellent reconstructive option. The use of an artificial dermal matrix in one-step surgical approach, allows rapid healing and early mobilization of the neck, and in selective cases, it may reduce the need for local-regional or free flap coverage; moreover, it is associated with excellent skin formation, good functional and esthetic results and minimal donor site morbidity.

Keywords

Neck / burns / matrix / template / reconstruction

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