Aseptically Processed Placental, Dermal and Adipose Tissue Matrices For Soft Tissue Reconstruction: A Review of 145 Cases
Krista Bauer (Montgomery), RN, WCC, OMS
Kurt Holifield, RN, BSN, WCC, OMS
Kari Day, RN, BSN, WCC
Denise Gilmore, RN
Ashley L. Wardman, LPN
Surgical reconstruction of chronic wounds using soft tissue flaps is a routine approach to achieve closure. Due to the poor tissue quality, longstanding inflammation, bioburden and impaired blood supply, the success of flap closure is marred by reported complication rates of 25-58%.1
Placental, dermal and adipose allografts are commonly used for resolving chronic wounds. To date, little has been reported about the use of these tissue forms to enhance surgical outcomes. We hypothesize that these tissue forms that have been utilized for chronic wound progression, may also be beneficial for patients who undergo surgical wound reconstruction.
We present a retrospective review of a series of 145 surgical reconstructive procedures over a two year period using aseptically processed placental and dermal grafts without terminal sterilization which is known to maintain the inherent growth factors and matrix proteins native to the tissue. All of which are known to support wound closure.2,3 Specifically, we found that while surgical outcomes improved, it appears that even when there was a postsurgical wound complication, most were able to be reclosed and or healed secondarily. All healed defects exhibited acceptable cosmesis and “normal” function, with 100% patient satisfaction.
The addition of aseptically processed allografts without terminal sterilization to reconstructive surgical flaps may improve outcomes. Maintaining inherent growth factors and matrix proteins are postulations while the exact mechanism is not known. It is likely however, that the same mechanism that allows these allografts to optimize wound progression may also enhance surgical success. We advocate the addition of aseptically processed allograft tissue matrices during surgical reconstruction of challenging chronic soft tissue defects to help optimize success and help prepare for secondary healing if a complication does occur.