gms | German Medical Science

Objectives/Interrogation: Hyalomatrix is a skin graft substitute that may be able to be utilized as an alternative to partial or full thickness skin grafts in a variety of procedures involving the pediatric upper extremity. Composed of an esterified Hyaluronic Acid layer and a silicone layer, Hyalomatrix provides a matrix for dermal induction while protecting the wound from the external environment. The use of this skin graft substitute can potentially decrease the overall operative time associated with a procedure since there is no need to harvest skin graft. The purpose of this study was to assess the outcomes and complications of procedures incorporating Hyalomatrix during pediatric upper extremity procedures.

Methods: Patients were identified utilizing a search of Current Procedural Terminology (CPT) codes to identify patients that had a dermal substitute (Hyalomatrix) utilized. Each identified patient's chart was reviewed retrospectively to assess for functionality (ability to return to daily activities), recovery time (time taken to return to daily activities), and complications associated with the use of Hyalomatrix. Basic statistical analysis was performed.

Results and Conclusions: Hyalomatrix was utilized in 12 procedures, performed on 10 unique individuals, and was applied to 25 total wound sites. Indications for use of Hyalomatrix included syndactyly release procedures, areas lacking coverage following contracture releases, and substantial road rash wounds. The average length of follow-up associated with the Hyalomatrix application was 11.18 (10.97) weeks. Successful healing was achieved in 90% of patients. One patient required a return to the operating room due to recurrent syndactyly, at which time Hyalomatrix was again utilized. Minor complications were noted, including the development of a pyogenic granuloma (n=1), serosanguinous drainage (n=2), and mild scar hypertrophy (n=1). One patient experienced a keloid formation at the operative site (n=1), although it is important to note that this patient had a history of prior keloid formation. No infections were observed in these patients.

Hyalomatrix is a viable dermal substitute for a variety of pediatric upper extremity conditions. The use of Hylomatrix dermal substitute may reduce operative time by negating the need to obtain skin graft while decreasing potential morbidity to the patient. Further prospective investigations into the use of this skin graft substitute are warranted.