Dr Nicholas Linklater¹, Rebecca Schrale², Yvonne Echaburu², Mr Andrew Castley²

¹ Royal Hobart Hospital, 48 Liverpool Street, Hobart, Tasmania, 7000, weezy0607@gmail.com
² Royal Hobart Hospital, 48 Liverpool Street, Hobart, Tasmania, 7000, rhhburnscnc@dhhs.tas.gov.au

We present a case of a 23 year old who sustained 53 % TBSA flame burn from nightdress catching fire from a bar heater when aged four. Following multiple operations and treatments with other dermal substitutes (Integra) for contractures, she represented with severe neck contractures and webbing. Initial scar release and dermal substitute with Integra was used 6 months prior which resulted in further contracture of the lateral neck area. A repeat operation with a new line dermal substitute MatriDerm was trialled in order to attempt to overcome some of the issues previously experienced.

The major issues included graft loss in a patient with very limited and poor quality donor sites, which have been subjected to multiple harvesting, hypertrophic scaring and issues of scar maturation & ongoing scar contraction.

MatriDerm is a dermal substitute that is suitable for a one step repair of a full thickness defect with a STSG. MatriDerm is a scaffold that consists of a bovine type1,3&5 collagen fibre template incorporating elastin hydrolysate that is converted into native host collagen within weeks following application. The advantages are a cost effective one step procedure, with faster patient rehabilitation and a reduced length of stay in hospital.

We present our results up to three months follow up, reviewing the elements of management that worked well and those issues which posed significant challenges in a difficult area of scar contracture.

Key Words

MatriDerm, dermal substitute, scar contracture

Biography

Plastics registrar at RHH 2014-2015