Usefulness of Artificial Dermis ( Alloderm and Terudermis ) for Reconstruction of Soft Tissue Defect

Kim, Seon Woong; Kim, Yeon Soo; Hong, In Pyo; Kim, Jong Whan

Abstract

There remains many difficult problems for plastic surgeons when they try to reconstruct soft tissue defect, especially defect on lower extremity with poor vascularity. We experienced two kinds of artificial dermis, Alloderm (LifeCell Corporation, USA) and Terudermis(Terumo, Japan). We applied them for 12 patients from October 1998 to May 1999. Their wounds had various causes. The authors debrided the necrotic tissue and got the artificial dermis soaked enough in saline. After fixing the artificial dermis with suture fixation, thin STSG was harvested. Applying the thin STSG on artificial dermis and Tie-over dressing were done to prevent mobilization. From our experience we had several suggestions to keep in mind. Preoperatively, you have to decrease the discharge with frequent dressing change. Intraoperativeiy, in order to avoid the mobilizaion between the artificial dermis and STSG, you have to fix them well with suture fixation. Postoperatively, the larger is the exposed bone or tendon, the longer the splint applying time is required. Nine patients out of 12 patients(75%) had no problem. Three patients underwent partial loss. Two patients suffered from infection or rough dressing. One patient failed due to careless mobilization before the artificial dermis is completely settled. The authors recommend to appky the artificial dermis rather than more aggressive procedures when the wound size is smaller than 2 x 4 cm with bone or tendon exposure. The authors think that the artificial dermis is also very useful to prevent postoperative scar contracture.