Page 73 - ARNM-2-2

Advances in Radiotherapy &

Nuclear Medicine

CASE SERIES
Staged wound reconstruction utilizing

regenerative dermal matrix followed by
split-thickness skin grafting in the setting of

local radiation: A case series with review of the
literature

3
1
Emily S. Baruch , Kristina M. Crawford 2 , and Matthew R. Endara *
1 Lincoln Memorial University, Harrogate, Tennessee, United States of America
2 Plastic and Reconstructive Surgery, University of Florida, Gainesville, Florida, United States of America
3 Maury Regional Medical Center, Lincoln Memorial University, Plastic and Reconstructive Surgeon,
Columbia, Tennessee, United States of America

Abstract

The use of radiation for local control following tumor extirpation has improved
outcomes across the spectrum of oncologic conditions. Reconstructive strategies
that improve short-term healing rates and long-term results in these complicated
wound healing environments are paramount to success. Regenerative dermal
matrices (RDM) have emerged as viable options to improve reconstructive outcomes
*Corresponding author: in the field of radiology. Here, we present a case series highlighting our algorithm of
Matthew Endara
(mendara@mauryregional.com) staged reconstruction using regenerative dermal matrix followed by split-thickness
skin grafting to reconstruct skin deficits following excision of tumors either before or
Citation: Baruch ES, Crawford
KM, Endara MR. Staged wound after radiation. A systematic review of the literature pertaining to irradiated wound
reconstruction utilizing regenerative closure and the application of dermal regenerative templates is presented to better
dermal matrix followed by split- understand its emerging role to manage these complex cases and impact future
thickness skin grafting in the
setting of local radiation: A outcomes. Six patients underwent staged reconstruction using our algorithm, all of
case series with review of the which went on to heal completely without additional procedures or evidence of skin
literature. Adv Radiother Nucl Med. breakdown in the short and long term. RDMs seem to improve the radioresistance
2024;2(2):3388.
doi: 10.36922/arnm.3388 of surgically reconstructed wounds following excision of cancer. The mechanism for
this is likely related to the creation of additional tissue layers beyond those replaced
Received: April 9, 2024 with skin graft alone and should be the subject of future study.
Accepted: May 31, 2024
Published Online: June 20, 2024 Keywords: Integra; Radiation wounds; Reconstruction; Regenerative dermal matrix;
Copyright: © 2024 Author(s). Plastic surgery; Skin graft
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium, 1. Introduction
provided the original work is
properly cited. Radiation-induced tissue damage and the unique challenges it poses to reconstructive
Publisher’s Note: AccScience surgeons are thoroughly studied topics in the plastic surgery and oncology literature. 1-11
Publishing remains neutral with It has long been recognized that skin damaged by radiotherapy is difficult to heal. This
regard to jurisdictional claims in
published maps and institutional compromised wound healing has been attributed to the injuries imposed by radiation
affiliations exposure, namely DNA damage that leads to impaired functioning and decreased

Volume 2 Issue 2 (2024) 1 doi: 10.36922/arnm.3388