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Case Series/Study
The reconstructive ladder serves as a stepwise approach in determining an appropriate path to reconstruction and wound closure. The addition of skin substitutes has provided a plethora of advanced tissue grafts to support the goals of reconstruction. The application of human dermal matrix substitutes can provide a scaffold with matrix proteins and replace the damaged integument. Aseptically processed meshed human reticular acellular dermal matrix (HR-ADM) provides an open, uniform scaffold with preserved matrix proteins that support host infiltration, integration, and reconstruction of damaged or excised tissue. In addition, placental allografts provide native matrix proteins and support wound progression. The repair with like tissue culminates in more durable tissue that is functional and stable.
Methods:
This case series presents the application of meshed HR-ADM and placental tissue, which are bothaseptically processed without terminal irradiation, to provide a scaffold for host repopulation and support reconstruction and wound closure. The meshed HR-ADM and placental tissue was applied and secured in place. Standard treatment protocols were followed until complete closure was achieved.
Results:
Graft integration and wound closure was observed. The meshed HR-ADM and placental tissue provided the missing scaffold that was required for supporting tissue reconstruction. The tissue was vascularized and incorporated, culminating in full closure. The patients were complex cases and were treated successfully.
Discussion:
Meshed HR-ADM provides the missing dermal framework that is remodeled and integrated to replace the damaged or missing soft tissue. This preserved structure and extracellular matrix proteins support tissue reconstruction and wound closure. The aseptically processed placental tissue is known to maintain native matrix proteins and growth factors, which also support wound closure.