Use of tissue-engineered skin in the dermal atrophy patient with traumatic avulsion injuries.

Tissue-engineered skin has been approved by the Food and Drug Administration for use in certain chronic ulcers (venous stasis ulcers and diabetic foot ulcers). Its use has also been reported in acute (surgical) excisional wounds. The authors report the use of tissue-engineered skin in traumatic avulsion wounds in a series of 10 patients with dermal atrophy. All patients were older than 60 years of age and clinically had thin, atrophic skin. Most were older than 70 years of age and were steroid users. Tissue-engineered skin (Apligraf or Living Skin Equivalent; Novartis, Canton, MA) was used for subacute and acute wound coverage. All wounds healed 100%. Average healing time overall was 9.2 weeks. No wound has recurred with an average follow-up of 14 months. There were no wound infections. The authors conclude that tissue-engineered skin provides a safe, efficacious, and convenient solution for acute avulsion wounds in the patient with age-and/or steroid-related dermal atrophy.