Case Reports
25 October 2024
Vol. 17 No. 1 (2025)
Reconstruction of hand surgical wounds after pseudo-syndactyly correction or squamous cell carcinoma resection in patients affected from epidermolysis bullosa: a monocentric experience with a collagen-elastin dermal matrix substitute
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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In patients with epidermolysis bullosa (EB), surgery may be required to remove squamous cell carcinoma (SCC) of the hands or to correct pseudo-syndactyly. Dermal substitutes may represent a suitable tool to promote the healing of surgical wounds in EB. We review our experience with a collagen-elastin dermal matrix to promote surgical wound healing due to hand surgery to correct pseudo-syndactyly or SCC resection in patients affected by EB. Overall, 12 patients (mean age, 29±11 years, range 13-51; four females) with EB were considered, with a total of 25 different interventions (16 SCC removals; 3 amputations for recurrent infiltrating SCC; 6 pseudo-syndactyly corrections). All patients received a collagen-elastin dermal matrix sheet. Neodermis was achieved in all patients, and no adverse events potentially associated with the graft occurred. No SCC recurrence was reported at sites operated for either SCC resection or amputation. The opening of the first or second commissure appears to be maintained for over 1 year after the procedure, preserving digital function. We believe that the application of a dermal substitute, together with a close dressing protocol, may represent a suitable strategy for obtaining physiological tissue regeneration and maintaining proper hand function in patients with EB.
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Natsuga K, Shinkuma S, Hsu CK, et al. Current topics in epidermolysis bullosa: pathophysiology and therapeutic challenges. J Dermatol Sci 2021;104:164-76.
Box R, Bernardis C, Pleshkov A, et al. Hand surgery and hand therapy clinical practice guideline for epidermolysis bullosa. Orphanet J Rare Dis 2022;17:406.
du Rand A, Hunt JMT, Feisst V, Sheppard HM. epidermolysis bullosa: a review of the tissue-engineered skin substitutes used to treat wounds. Mol Diagn Ther 2022;26:627-43.
Abboud L, Leclerc-Mercier S, Bodemer C, Guéro S. Hand surgery in recessive dystrophic epidermolysis bullosa: our experience with dermal substitutes. J Plast Reconstr Aesthet Surg 2022;75:314-24.
Condorelli AG, Dellambra E, Logli E, et al. epidermolysis bullosa-associated squamous cell carcinoma: from pathogenesis to therapeutic perspectives. Int J Mol Sci 2019;20:5707.
Paganelli A, Reggiani C, Fiorentini C, et al. Surgical management of squamous cell carcinoma arising in patients affected by epidermolysis bullosa: a comparative study. Int Wound J 2020;17:519-21.
Rotschein P, Vokurková J, Bučková H. Surgical treatment and management of cutaneous squamous cell carcinoma in patients with dystrophic epidermolysis bullosa - a case report. Acta Chir Plast 2021;63:196-200.
Tchero H, Herlin C, Bekara F, et al. Failure rates of artificial dermis products in treatment of diabetic foot ulcer: A systematic review and network meta-analysis. Wound Repair Regen 2017;25:691-6.
Dickson K, Lee KC, Abdulsalam A, et al. A Histological and clinical study of MatriDerm® use in burn reconstruction. J Burn Care Res 2023:irad024.
Hones KM, Hones J, Satteson ES, Chim H. Treatment of complex extremity wounds with MatriDerm: first clinical experience in the US. J Wound Care 2023;32:167-71.
Paganelli A, Naselli AG, Bertoni L, et al. Wound healing after acellular dermal substitute positioning in dermato-oncological surgery: a prospective comparative study. Life (Basel) 2023;13:463.
Salloum A, Bazzi N, Squires S, et al. Comparing the application of various engineered xenografts for skin defects: a systematic review. J Cosmet Dermatol 2023;22:921-31.
De Angelis B, Gentile P, Agovino A, et al. Chronic ulcers: MATRIDERM(®) system in smoker, cardiopathic, and diabetic patients. J Tissue Eng 2013;4:2041731413502663.
Mandel VD, Persechino F, Fiorentini C, et al. Treatment of chronic infected post-oncological wounds with a dermal matrix: two case studies. J Wound Care 2018;27:558-62.
Abbate V, Iaconetta G, Sani L, et al. The use of dermal substitutes for donor site closure after radial forearm free flap harvesting. J Craniofac Surg 2021;32:e205-8.
Campagnari M, Jafelicci AS, Carneiro HA, et al. Dermal substitutes use in reconstructive surgery for skin tumors: a single-center experience. Int J Surg Oncol 2017;2017:9805980.
Charvillat O, Plancq MC, Haraux E, et al. Aplasia cutis congenita of both knees: a new therapeutic strategy. Arch Pediatr 2020;27:277-80.
Duteille F, Truffandier MV, Perrot P. ‘Matriderm’ dermal substitute with split-thickness skin graft compared with full-thickness skin graft for the coverage of skin defects after surgical treatment of congenital syndactyly: results in 40 commissures. J Hand Surg Eur Vol 2016;41:350-1.
Jackson SR, Roman S. matriderm and split skin grafting for full-thickness pediatric facial burns. J Burn Care Res 2019;40:251-4.
Fulchignoni C, Rocchi L, Cauteruccio M, Merendi G. Matriderm dermal substitute in treating post traumatic hand's fingertip tissue loss. J Cosmet Dermatol 2022;21:750-7.
Mellerio JE, Robertson SJ, Bernardis C, et al. Management of cutaneous squamous cell carcinoma in patients with epidermolysis bullosa: best clinical practice guidelines. Br J Dermatol 2016;174:56-67.
Véliz S, Huber H, Yubero MJ, et al. Early teeth extraction in patients with generalized recessive dystrophic epidermolysis bullosa: a case series. Spec Care Dentist 2020;40:561-5.
Polizzi A, Santonocito S, Patini R, et al. Oral alterations in heritable epidermolysis bullosa: a clinical study and literature review. Biomed Res Int 2022;2022:6493156.
van den Heuvel I, Gottschalk A, Langer M, et al. Feasibility, efficacy, and safety of ultrasound-guided axillary plexus blockade in pediatric patients with epidermolysis bullosa dystrophica. Paediatr Anaesth 2016;26:405-8.
Zhou X, Zhang Y, Zhao M, et al. Surgical management of hand deformities in patients with recessive dystrophic epidermolysis bullosa. J Plast Surg Hand Surg 2020;54:33-9.
Bellei B, Govoni FA, Bertozzi E, et al. Restoring full-thickness skin defects with a dermal regeneration template and dermal-epidermal cell suspension in a patient with junctional epidermolysis bullosa. Eur J Dermatol 2020;30:3722.
Supporting Agencies
This work was made possible by an unrestricted grant from MedSkin. This project is developed within ERN-Skin.How to Cite
Reconstruction of hand surgical wounds after pseudo-syndactyly correction or squamous cell carcinoma resection in patients affected from epidermolysis bullosa: a monocentric experience with a collagen-elastin dermal matrix substitute. (2024). Dermatology Reports, 17(1). https://doi.org/10.4081/dr.2024.10016
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