Skip to main content
Top
Published in: European Journal of Plastic Surgery 2/2016

01-04-2016 | Original Paper

The use of dermal regeneration template (Pelnac®) in acute full-thickness wound closure: A case series

Authors: Winy Widjaja, Peter Maitz

Published in: European Journal of Plastic Surgery | Issue 2/2016

Login to get access

Abstract

Background

Dermal regeneration template (DRT) has been well implicated in the reconstruction of full-thickness burn injury. This case series specifically presents our experience and our clinical application of Pelnac® to achieve wound closure with complex acute full-thickness defect.

Methods

A retrospective review of patients treated with Pelnac for complex wound defects from 2008 to 2014 at Concord Burns Unit was carried out. Variables such as wound aetiology, wound size and complications were considered.

Results

Five patients (four females and one male with a mean age 54 ± 20) all had full-thickness defects (mean defect size 4.3 ± 2.0 % TBSA), some with exposed tendon and bone. The wounds were treated with Pelnac®; the silicone layer was removed at postoperative day 14 and a split-thickness skin graft (0.2 to 0.3 mm) was applied. Clinically, the reconstructed areas demonstrated good granulation tissue at 14 days with good take of the skin graft. There were no major acute graft loss, rejection or associated infection. However, there were small areas of graft loss which did not require re-grafting.

Conclusions

DRT provides a safe and efficacious alternative when dealing with acute contaminated full-thickness wounds. Pelnac® seems versatile in obtaining wound coverage in difficult complex wounds, especially in critically ill patients where free or pedicle flap reconstruction would be problematic.
Level of Evidence: Level V, therapeutic study.
Literature
1.
go back to reference Yannas IV, Burke JF (1980) Design of an artificial skin. I. Basic design principles. J Biomed Mater Res 14(1):65–81CrossRefPubMed Yannas IV, Burke JF (1980) Design of an artificial skin. I. Basic design principles. J Biomed Mater Res 14(1):65–81CrossRefPubMed
2.
go back to reference Yannas IV, Burke JF, Gordon PL, Huang C, Rubenstein RH (1980) Design of an artificial skin. II. Control of chemical composition. J Biomed Mater Res 14(2):107–32CrossRefPubMed Yannas IV, Burke JF, Gordon PL, Huang C, Rubenstein RH (1980) Design of an artificial skin. II. Control of chemical composition. J Biomed Mater Res 14(2):107–32CrossRefPubMed
3.
go back to reference Dagalakis N, Flink J, Stasikelis P, Burke JF, Yannas IV (1980) Design of an artificial skin. Part III. Control of pore structure. J Biomed Mater Res 14(4):511–28CrossRefPubMed Dagalakis N, Flink J, Stasikelis P, Burke JF, Yannas IV (1980) Design of an artificial skin. Part III. Control of pore structure. J Biomed Mater Res 14(4):511–28CrossRefPubMed
4.
go back to reference Moiemen N, Yarrow J, Hodgson E, Constantinides J, Chipp E, Oakley H et al (2011) Long-term clinical and histological analysis of Integra dermal regeneration template. Plast Reconstr Surg 127(3):1149–54CrossRefPubMed Moiemen N, Yarrow J, Hodgson E, Constantinides J, Chipp E, Oakley H et al (2011) Long-term clinical and histological analysis of Integra dermal regeneration template. Plast Reconstr Surg 127(3):1149–54CrossRefPubMed
5.
go back to reference Bloemen MCT, van Leeuwen MCE, van Vucht NE, van Zuijlen PPM, Middelkoop E (2010) Dermal substitution in acute burns and reconstructive surgery: a 12-year follow-up. Plast Reconstr Surg 125(5):1450–9CrossRefPubMed Bloemen MCT, van Leeuwen MCE, van Vucht NE, van Zuijlen PPM, Middelkoop E (2010) Dermal substitution in acute burns and reconstructive surgery: a 12-year follow-up. Plast Reconstr Surg 125(5):1450–9CrossRefPubMed
6.
go back to reference Burke JF, Yannas IV, Quinby WC, Bondoc CC, Jung WK (1981) Successful use of a physiologically acceptable artificial skin in the treatment of extensive burn injury. Ann Surg 194(4):413–28CrossRefPubMedPubMedCentral Burke JF, Yannas IV, Quinby WC, Bondoc CC, Jung WK (1981) Successful use of a physiologically acceptable artificial skin in the treatment of extensive burn injury. Ann Surg 194(4):413–28CrossRefPubMedPubMedCentral
7.
go back to reference Suzuki S, Matsuda K, Nishimura Y, Maruguchi Y, Maruguchi T, Ikada Y et al (1996) Review of acellular and cellular artificial skins. Tissue Eng 2(4):267–75CrossRefPubMed Suzuki S, Matsuda K, Nishimura Y, Maruguchi Y, Maruguchi T, Ikada Y et al (1996) Review of acellular and cellular artificial skins. Tissue Eng 2(4):267–75CrossRefPubMed
8.
go back to reference Suzuki S, Matsuda K, Isshiki N, Tamada Y, Ikada Y (1990) Experimental study of a newly developed bilayer artificial skin. Biomaterials 11(5):356–60CrossRefPubMed Suzuki S, Matsuda K, Isshiki N, Tamada Y, Ikada Y (1990) Experimental study of a newly developed bilayer artificial skin. Biomaterials 11(5):356–60CrossRefPubMed
9.
go back to reference Muangman P, Engrav LH, Heimbach DM, Harunari N, Honari S, Gibran NS et al (2006) Complex wound management utilizing an artificial dermal matrix. Ann Plast Surg 57(2):199–202CrossRefPubMed Muangman P, Engrav LH, Heimbach DM, Harunari N, Honari S, Gibran NS et al (2006) Complex wound management utilizing an artificial dermal matrix. Ann Plast Surg 57(2):199–202CrossRefPubMed
10.
go back to reference Koenen W, Felcht M, Vockenroth K, Sassmann G, Goerdt S, Faulhaber J (2011) One-stage reconstruction of deep facial defects with a single layer dermal regeneration template: single layer dermal regeneration template in the face. J Eur Acad Dermatol Venereol 25(7):788–93CrossRefPubMed Koenen W, Felcht M, Vockenroth K, Sassmann G, Goerdt S, Faulhaber J (2011) One-stage reconstruction of deep facial defects with a single layer dermal regeneration template: single layer dermal regeneration template in the face. J Eur Acad Dermatol Venereol 25(7):788–93CrossRefPubMed
11.
go back to reference Demiri E, Papaconstantinou A, Dionyssiou D, Dionyssopoulos A, Kaidoglou K, Efstratiou I (2013) Reconstruction of skin avulsion injuries of the upper extremity with Integra® dermal regeneration template and skin grafts in a single-stage procedure. Arch Orthop Trauma Surg 133(11):1521–6CrossRefPubMed Demiri E, Papaconstantinou A, Dionyssiou D, Dionyssopoulos A, Kaidoglou K, Efstratiou I (2013) Reconstruction of skin avulsion injuries of the upper extremity with Integra® dermal regeneration template and skin grafts in a single-stage procedure. Arch Orthop Trauma Surg 133(11):1521–6CrossRefPubMed
12.
go back to reference Abbas Khan MA, Chipp E, Hardwicke J, Srinivasan K, Shaw S, Rayatt S (2010) The use of dermal regeneration template (Integra®) for reconstruction of a large full-thickness scalp and calvarial defect with exposed dura. J Plast Reconstr Aesthet Surg 63(12):2168–71CrossRefPubMed Abbas Khan MA, Chipp E, Hardwicke J, Srinivasan K, Shaw S, Rayatt S (2010) The use of dermal regeneration template (Integra®) for reconstruction of a large full-thickness scalp and calvarial defect with exposed dura. J Plast Reconstr Aesthet Surg 63(12):2168–71CrossRefPubMed
13.
go back to reference Baynosa RC, Browder LK, Jones SR, Oliver JA, Van Der Harten CA, Stephenson LL et al (2009) Evaluation of artificial dermis neovascularization in an avascular wound. J Reconstr Microsurg 25(7):405–10CrossRefPubMed Baynosa RC, Browder LK, Jones SR, Oliver JA, Van Der Harten CA, Stephenson LL et al (2009) Evaluation of artificial dermis neovascularization in an avascular wound. J Reconstr Microsurg 25(7):405–10CrossRefPubMed
14.
go back to reference Hulsen J, Diederich R, Neumeister MW, Bueno RA (2014) Integra® dermal regenerative template application on exposed tendon. Hand (NY) 9(4):539–42 Hulsen J, Diederich R, Neumeister MW, Bueno RA (2014) Integra® dermal regenerative template application on exposed tendon. Hand (NY) 9(4):539–42
15.
go back to reference Suzuki S, Matsuda K, Isshiki N, Tamada Y, Yoshioka K, Ikada Y (1990) Clinical evaluation of a new bilayer “artificial skin” composed of collagen sponge and silicone layer. Br J Plast Surg 43(1):47–54CrossRefPubMed Suzuki S, Matsuda K, Isshiki N, Tamada Y, Yoshioka K, Ikada Y (1990) Clinical evaluation of a new bilayer “artificial skin” composed of collagen sponge and silicone layer. Br J Plast Surg 43(1):47–54CrossRefPubMed
16.
go back to reference Brusselaers N, Pirayesh A, Hoeksema H, Richters CD, Verbelen J, Beele H et al (2010) Skin replacement in burn wounds. J Trauma Inj Infect Crit Care 68(2):490–501CrossRef Brusselaers N, Pirayesh A, Hoeksema H, Richters CD, Verbelen J, Beele H et al (2010) Skin replacement in burn wounds. J Trauma Inj Infect Crit Care 68(2):490–501CrossRef
17.
go back to reference Matsuda K, Suzuki S, Isshiki N, Yoshioka K, Okada T, Ikada Y (1990) Influence of glycosaminoglycans on the collagen sponge component of a bilayer artificial skin. Biomaterials 11(5):351–5CrossRefPubMed Matsuda K, Suzuki S, Isshiki N, Yoshioka K, Okada T, Ikada Y (1990) Influence of glycosaminoglycans on the collagen sponge component of a bilayer artificial skin. Biomaterials 11(5):351–5CrossRefPubMed
18.
go back to reference Suzuki S, Morimoto N, Yamawaki S, Fujitaka J, Kawai K (2013) A case of giant naevus followed up for 22 years after treatment with artificial dermis. J Plast Reconstr Aesthet Surg 66(8):e229–e233CrossRefPubMed Suzuki S, Morimoto N, Yamawaki S, Fujitaka J, Kawai K (2013) A case of giant naevus followed up for 22 years after treatment with artificial dermis. J Plast Reconstr Aesthet Surg 66(8):e229–e233CrossRefPubMed
19.
go back to reference Llanos S, Danilla S, Barraza C, Armijo E, Piñeros JL, Quintas M et al (2006) Effectiveness of negative pressure closure in the integration of split thickness skin grafts: a randomized, double-masked, controlled trial. Ann Surg 244(5):700–5CrossRefPubMedPubMedCentral Llanos S, Danilla S, Barraza C, Armijo E, Piñeros JL, Quintas M et al (2006) Effectiveness of negative pressure closure in the integration of split thickness skin grafts: a randomized, double-masked, controlled trial. Ann Surg 244(5):700–5CrossRefPubMedPubMedCentral
20.
go back to reference Moisidis E, Heath T, Boorer C, Ho K, Deva AK (2004) A prospective, blinded, randomized, controlled clinical trial of topical negative pressure use in skin grafting. Plast Reconstr Surg 114(4):917–22CrossRefPubMed Moisidis E, Heath T, Boorer C, Ho K, Deva AK (2004) A prospective, blinded, randomized, controlled clinical trial of topical negative pressure use in skin grafting. Plast Reconstr Surg 114(4):917–22CrossRefPubMed
21.
go back to reference Eo S, Kim Y, Cho S (2011) Vacuum-assisted closure improves the incorporation of artificial dermis in soft tissue defects: Terudermis® and Pelnac®. Int Wound J 8(3):261–7CrossRefPubMed Eo S, Kim Y, Cho S (2011) Vacuum-assisted closure improves the incorporation of artificial dermis in soft tissue defects: Terudermis® and Pelnac®. Int Wound J 8(3):261–7CrossRefPubMed
Metadata
Title
The use of dermal regeneration template (Pelnac®) in acute full-thickness wound closure: A case series
Authors
Winy Widjaja
Peter Maitz
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Plastic Surgery / Issue 2/2016
Print ISSN: 0930-343X
Electronic ISSN: 1435-0130
DOI
https://doi.org/10.1007/s00238-015-1131-0

Other articles of this Issue 2/2016

European Journal of Plastic Surgery 2/2016 Go to the issue