Practice Innovations
The etiology of facial and neck soft tissue loss may be traumatic, iatrogenic, or simply a feature of aging. There are a variety of traditional methods for facial and neck contouring, however, these options have associated limitations. For example, fat grafting is not always long-lasting1 and materials such as Gore-Tex are stiff, therefore, their application is relatively limited to non-animating areas. The Wound Matrix* was designed to stimulate neodermis formation as an overlay for wound coverage, however, given its pliable and stackable properties, it has potential to be utilized as a volumizing inlay - a premise based on existing evidence2.
Methods:
In this preliminary series, patients with significant fat atrophy undergoing face/neck lift, soft tissue mass removal or contour reconstruction after traumatic injury were treated with Wound Matrix* implants. Implants were placed at the time of surgery prior to wound closure. The implant was either folded, rolled or stacked depending on the location and depth of the defect. Photos of the reconstruction were obtained at the time of surgery and incrementally at postoperative clinic appointments. Patients were followed for up to 10 years after the initial surgery.
Results:
The Wound Matrix* was successfully incorporated in four cases as a flexible, tissue augmenting material, non-extruding with time. The results have not been associated with skin thinning, visualization, or palpability of the implant. Patients have demonstrated long-lasting excellent aesthetic outcomes. Additionally, patients did not experience a foreign body sensation.
Discussion:
This study demonstrates encouraging early and long-term results of facial and neck subcutaneous tissue reinforcement utilizing a Wound Matrix implant* with sheet-style volumization. Although his novel idea was initially an aesthetic model for testing the products efficacy in a new capacity, the senior author has expanded its utility to the treatment of soft tissue defects and wound sequela. The results exhibit concealment of contour irregularities, and natural-appearing augmented skin with layers that appear to glide across one another. Application of the Wound Matrix* yielded outcomes free of adhesions, which negated the risk of contour retraction upon movement of aesthetic units.
Trademarked Items: *Integra
References: 1. Lam SM, Glasgold RA, Glasgold MJ. Limitations, complications, and long-term sequelae of fat transfer. Facial Plast Surg Clin North Am. 2008 Nov;16(4):391-9, v. doi: 10.1016/j.fsc.2008.05.007.
2. Foley, E., Robinson, A. & Maloney, M. Skin Substitutes and Dermatology: A Review. Curr Derm Rep 2, 101–112 (2013). doi:0.1007/s13671-013-0044-z.