Long-term results of split-thickness skin grafting with and without additional dermal matrix in severe traumatic soft tissue defects of the lower limb

Purpose Aim of this study was to compare the use of split-thickness skin graft (STSG) with and without additional MatriDerm (R) application in a predominantly one-step procedure for the treatment of severe traumatic soft tissue defects of the lower limb. Methods This retrospective study included patients treated in a European level I trauma center between June 2013 and July 2018 in terms of a severe traumatic soft tissue defect of the lower extremity using STSG alone or in combination with the acellular dermal substitute MatriDerm (R). The healing of the soft tissue defect was measured by assessment of the take rate. Outcome quality of the scar tissue was assessed using the Vancouver Scar Scale. Results A total of 147 cases were included in this study. The overall healing rate (number of patients with take rate >= 75%) was 88/147 (60%) and did not demonstrate significant differences between the treatment groups (p = 0.15). Despite the difference in wound complexity between the treatment groups, there was no difference regarding the scar tissue quality 12 months postoperatively. In about 25% of all cases, a post-operative event was mentioned that had to be revised surgically. Conclusion Surgical treatment with STSG and additional MatriDerm (R) application can be recommended as satisfactory alternative for dermis replacement in patients with severe skin defects, independent of age. The additional MatriDerm (R) use allows for bridging of exposed ligaments, tendons, vessels or bones without relevant differences in cosmetical outcome.