Usage Of Dermal Template for Reconstruction of Complex defects - a prospective observational study

When facing wound reconstruction, trauma and plastic surgeons have different options

to choose from, including skin grafting, local, regional, distant pedicled and free flaps,

and tissue expansion(1). Yet, Skin and soft tissue reconstruction remains a challenge

for plastic surgeons because of optimal aesthetic and functional outcomes.

For many centuries, skin grafts have been used to restore wound defects after trauma,

vascular disease, or cancer. However, availability of sufficient healthy skin can be an

issue, as well as the additional health risks associated with the procedure. The

deforming donor-site morbidity should also be considered when opting for skin grafting.

Disadvantages as such have led to innovations in skin tissue engineering.

Dermal template offers multiple advantages: It prepares the wound before the

positioning of a split-thickness skin graft. It is applicable in anatomical regions in which a

graft placement alone would not be preferred, such as on bone and tendon-exposed

areas, and improves the final outcome and feature of the scar. The positioning of the

matrix is relatively simple with a reduction of operating time. It allows the reduction of

inpatient time in the hospital and of surgical sequelae for the patient. However, Dermal

Templates could also be susceptible to infection, need a second procedure for the

coverage of the matrix with a skin graft, and have a relatively high cost compared to

autografts. Dermal templates are playing an increasingly important role in reconstruction

of complex defects, however there is a lack of evidence on their long-term outcomes. In

India, there is a lack of comprehensive studies detailing use and outcomes of dermal

templates .We aimed to review the use, outcomes and complications of IDRT within our

tertiary care centre, KMC, Manipal.