The use of an acellular matrix derived from human dermis for the treatment of full-thickness skin wounds

Full-thickness skin wounds occur in many different clinical cases and the use of biological acellular dermal matrices (ADMs) to reconstruct the damaged area is increasing in the field of plastic and reconstructive surgery. In particular, the ability of ADMs to maintain the structural properties of extracellular matrix as well as to provide a suitable environment for cell growth makes their use suitable for the improvement of wound healing and the reduction of side effects deriving from contracture and scar tissue formation. In this study, we describe the clinical use of a recently developed human dermal matrix (HDM) in combination with graft skin as an alternative reconstructive solution for the treatment of full-thickness skin wounds. The HDM was applied in combination with autologous graft skin on three different clinical cases in which full-thickness skin wounds occurred. The clinical outcomes were evaluated in the patients during their follow-up. Histological as well as ultra-structural analysis were also performed on skin biopsy of the clinical case 3 one year after the treatment with HDM. The use of HDM stimulates the wound healing process in all clinical cases of full-thickness skin wounds here described with a functional and aesthetic rescue of the damaged area. Histological and ultra-structural analysis show a regenerative healing of the wound area with well-organized/oriented connective tissue in which cellular infiltration as well as blood vessels are evident. Our results support the clinical use of HDM as a permanent dermal replacement for the treatment of full-thickness skin wounds.