Sameer Shakir|Charles A. Messa|Robyn B. Broach|Irfan A. Rhemtulla|Brett C. Chatman|Albert M. D’Angelantonio|L. Scott Levin|Stephen J. Kovach|Joseph M. Serletti|John P. Fischer
Indications and Limitations of Bilayer Wound Matrix–Based Lower Extremity Reconstruction: A Multidisciplinary Case-Control Study of 191 Wounds
University of Pennsylvania|Creative Commons|Philadelphia University|University of Pennsylvania|Creative Commons|Philadelphia University|University of Pennsylvania|Creative Commons|Philadelphia University|University of Pennsylvania|Creative Commons|Philadelphia University|University of Pennsylvania|Creative Commons|Philadelphia University|University of Pennsylvania|Creative Commons|Philadelphia University|University of Pennsylvania|Creative Commons|Philadelphia University|University of Pennsylvania|Creative Commons|Philadelphia University|University of Pennsylvania|Creative Commons|Philadelphia University|University of Pennsylvania|Creative Commons|Philadelphia University
background little known efficacy newer skin substitute scaffolds reconstruct complex lower extremity wounds investigators present multihospital experience reconstructive surgeons utilizing collagengag bilayer wound matrix lower extremity softtissue reconstruction goals 1 characterize suitable patient population 2 categorize failures optimize patient selection 3 determine wound factors affecting success methods subjects underwent collagengagbased lower extremity wound reconstruction may 2010 june 2017 primary outcome variable 180day graft success defined eventual splitthickness skin grafting bilayer wound matrix application failure defined inadequate wound bed splitthickness skin grafting requirement vascularized tissue transfer eventual amputation eligible subjects least one lower extremity wound least 18 years old exclusion criteria included thirddegree burn wounds failure follow least 60 days postoperatively predictor variables included demographics medical comorbidities perioperative characteristics postoperative complications costrelated data hospitalization results 147 subjects 191 wounds mean patient age 601 years range 210 956 years mean body mass index 305 kgm 2 range 144 647 kgm 2 average wound size 731 1377 cm 2 490 percent subjects receiving adjunct postoperative negativepressure wound therapy seventy percent wounds successfully healed 180 days localized knee ankle 508 percent foot 461 percent tendon exposure p lt 005 bone exposure p lt 001 bone excision p lt 004 associated reconstructive failure conclusions authors present largest reported multihospital multidisciplinary experience collagengag wound matrix lower extremity reconstruction tendon andor bone exposure socioeconomic factors associated failure clinical questionlevel evidence risk iii