Use of a multilayered acellular dermal substitute with simultaneous full-thickness skin graft for the one-stage coverage of nasal skin defects

Abstract

Background Nasal skin defect closures are challenging because the nose is a complex anatomic structure with several subunits, and the nasal tip and ala represent particularly difficult subunits to reconstruct. The traditional full-thickness skin graft (FTSG) is an easy and well-established method, but often results in undesirable outcomes in terms of the nasal contour caused by a lack of dermal tissue. Aims The purpose of the study is to report the outcomes of the simultaneous application of the acellular dermal substitute (Matriderm (R)) with FTSG in the treatment of nasal skin defects. Patients/Methods Five patients with various nasal skin defects were treated with multilayered Matriderm grafts followed by FTSGs harvested from the pre- or postauricular region. Graft survival, scar quality, and patient satisfaction were evaluated and compared with 10 patients treated with conventional FTSGs. Results One-stage Matriderm-aided FTSGs were well-taken in all cases. Scar quality in the Matriderm group (8.0 +/- 1.9) was statistically superior to that in the FTSG only group (10.8 +/- 1.7). The Matriderm-aided graft was also superior in patient satisfaction. Conclusions The multilayered application of Matriderm in combination with FTSG is a reliable method for covering nasal skin defects, especially in the thick skin zone of the tip and ala.