Use of a Living Dermal Equivalent for a Refractory Abdominal Defect after Pediatric Multivisceral Transplantation

Authors: Carlos A. Charles1; Tomoaki Kato2; Andreas G. Tzakis2; Barbara N. Miller; Robert S. Kirsner

Source: Dermatologic Surgery, Volume 30, Number 9, September 2004 , pp. 1236-1240(5)

Publisher: Blackwell Publishing

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Abstract:

Background.

Primary closure is not always possible after pediatric multivisceral transplantation. Reepithelialization may require extended periods of postoperative time, which can be associated with significant morbidity Objective.

The objective was to accelerate secondary wound closure thereby minimizing infection or further complications in a pediatric multivisceral transplant patient. Methods.

Five applications of human fibroblast-derived dermis (Dermagraft, Smith and Nephew) were applied to the postsurgical defect of a pediatric multivisceral transplant patient over the course of 8 months. Routine wound care and observation was performed between human fibroblast-derived dermis applications. Results.

Human fibroblast-derived dermis stimulated healing and accelerated reepithelialization. Signs of clinical rejection or infection were not observed. Conclusion.

Reepithelialization can be aided in the postoperative period in pediatric multivisceral transplant patients with human fibroblast-derived dermis, thereby helping to deter complications associated with secondary wound closure. We have illustrated the successful use of a human fibroblast-derived dermis as an adjunct for wound healing in a complicated surgical defect.

CARLOS A. CHARLES, MD, TOMOAKI KATO, MD, ANDREAS G. TZAKIS, MD, BARBARA N. MILLER, AND ROBERT S. KIRSNER, MD HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS.

Document Type: Research article

DOI: 10.1111/j.1524-4725.2004.30383.x

Affiliations: 1: Department of Dermatology and Cutaneous Surgery, 2: Division of Transplantation/Department of Surgery, University of Miami School of Medicine, Miami, Florida; and

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