Aseptically Processed Pre-Meshed Human Reticular Acellular Dermal Matrices* Support Wound Closure in Lower Extremity Wounds

IntroductionComplex wounds negatively impact patient lives and can be challenging to close. Aseptically processed pre-meshed human reticular acellular dermal matrices (HR-ADMs) can provide the native architecture for host cell infiltration and aid with natural wound closure [1]. This study examines how pre-meshed HR-ADMs can facilitate in closing complex wounds.MethodsA 77 year old female had multiple large wounds on both lower extremities after a motor vehicle accident. Another 72 year old female presented with an infected open wound of her right lower extremity and had been unsuccessfully treated in the wound care center with multiple modalities. In both cases, the wounds were to the level of the deep fascia tissue and bone, with significant presence of malodor with the necrotic tissue. Incision and drainage with aggressive debridement removing all the necrotic tissue was performed, and negative pressure wound therapy was used. Once the infection cleared, pre-meshed HR-ADM was sutured in place to assist with granulation and help fill in the depth of the wound. Subsequently, the patients underwent split thickness skin grafts (STSG) to close the wound.ResultsFull wound closure was achieved in both cases after application of the pre-meshed HR-ADM and STSG. The patients have maintained active lifestyles with no ulcer recurrence.DiscussionThe pre-meshed HR-ADM assisted in wound closure. The meshed pattern of the allograft allows the tissue to stretch significantly from its original size and conform to wounds while allowing the patient’s own cells to rebuild the tissue.