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Coverage of Deep Cutaneous Wounds Using Dermal Template in Combination with Negative-pressure Therapy and Subsequent Skin Graft

Milcheski, Dimas A. PhD*; Chang, Alexandre A. MD*; Lobato, Rodolfo C. MD; Nakamoto, Hugo A. PhD*; Tuma, Paulo Jr PhD*; Ferreira, Marcus C. PhD*

Plastic and Reconstructive Surgery – Global Open: June 2014 - Volume 2 - Issue 6 - p e170
doi: 10.1097/GOX.0000000000000108
Original Articles
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Background: We consider the use of dermal matrix associated with a skin graft to cover deep wounds in the extremities when tendon and bone are exposed. The objective of this article was to evaluate the efficacy of covering acute deep wounds through the use of a dermal regeneration template (Integra) associated with vacuum therapy and subsequent skin grafting.

Methods: Twenty patients were evaluated prospectively. All of them had acute (up to 3 weeks) deep wounds in the limbs. We consider a deep wound to be that with exposure of bone, tendon, or joint.

Results: The average area of integration of the dermal regeneration template was 86.5%. There was complete integration of the skin graft over the dermal matrix in 14 patients (70%), partial integration in 5 patients (25%), and total loss in 1 case (5%). The wound has completely closed in 95% of patients.

Conclusions: The use of Integra dermal template associated with negative-pressure therapy and skin grafting showed an adequate rate of resolution of deep wounds with low morbidity.

From the *Division of Plastic Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; and Division of General Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.

Received for publication November 8, 2013; accepted April 7, 2014.

Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors.

Dimas André Milcheski, PhD, Division of Plastic Surgery, Faculty of Medicine, University of São Paulo, Rua Alves Guimarães, 855, ap 54, Pinheiros, São Paulo, SP, Brazil, E-mail:

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© 2014 American Society of Plastic Surgeons