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The Use of Integra® Dermal Regeneration Template in the Reconstruction of Traumatic Degloving Injuries

Graham, G. Peter MD*; Helmer, Stephen D. PhD*; Haan, James M. MD*†; Khandelwal, Anjay MD*

doi: 10.1097/BCR.0b013e3182853eaf
Original Articles

Traumatic soft tissue, or “degloving” injuries from trauma are common. These injuries are a result of shearing and disrupt tissue planes, such as the junction between muscle and bone. Traditional repair involves debridement followed by skin grafting or flap reconstruction. Many degloving injuries, however, extend to bone or tendon and the decreased vascularity of the wound bed can compromise the success of traditional repairs. Additionally, medical comorbidities make some patients poor candidates for flap reconstruction. The purpose of this study was to evaluate the success of a dermal regeneration template in the treatment of complex traumatic degloving injuries at an American College of Surgeons verified Level 1 Trauma Center. A retrospective review was conducted on all patients sustaining traumatic degloving injuries from January 2009 to July 2010, who were treated with Integra® Dermal Regeneration Template followed by split-thickness autografting. Medical records were reviewed and patient demographics, injury characteristics, comorbidities, hospital course, and outcomes were summarized. Ten patients were studied. All had traumatic degloving injuries of an extremity ranging from 50 to 1000 cm2. Nine had injuries extending to bone and/or tendon. After debridement, patients underwent placement of Integra® followed by a split-thickness skin graft. Of the 10 patients nine had complete take of their grafts with excellent cosmetic and functional results. Degloving injuries are common in trauma. These injuries often extend to tendon and bone, which poses challenges to repair because of decreased vascularity. Placement of a dermal regeneration template followed by a split-thickness autograft is a viable alternative to traditional methods of repair.

From the *Department of Surgery, University of Kansas School of Medicine, Wichita; and Department of Trauma Services, Via Christi Hospital on Saint Francis, Wichita, Kansas.

Presented as a poster at the 44th Annual Meeting of the American Burn Association, Seattle, Washington, April 24–27, 2012.

Address correspondence to James M. Haan, MD, Department of Trauma Services, Room 2514, Via Christi Hospital on Saint Francis Street, 929 N. Saint Francis Street, Wichita, KS 67214.

© 2013 The American Burn Association