DERMAL SUBSTITUTES IN COMPLEX WOUND CARE: COMPARING THE EFFICACY OF INTEGRA AND MATRIDERM

Abstract

Background: Reconstruction of full-thickness soft-tissue defects involving exposed tendons, bone, or extensive body-surface loss remains a persistent challenge in reconstructive surgery. Acellular dermal regeneration templates (DRTs) provide a collagen-based extracellular matrix scaffold that supports neodermal regeneration, mitigates scar contracture, and improves functional recovery. Integra® and Matriderm® are among the most widely applied bioengineered templates, yet their comparative workflows and grafting timelines in routine practice remain incompletely characterised. Materials and Methods: A retrospective, single-centre observational study reviewed institutional records of ten patients, treated over a three-year period (2021–2024), with complex full-thickness defects secondary to electrical burns, road traffic accidents, extravasation injury, snake-bite envenomation (PIRA), or diabetic foot, who underwent staged wound-bed preparation followed by Integra or Matriderm application. Variables analysed included demographics, wound aetiology, anatomical distribution, adjuvant negative-pressure wound therapy (NPWT/VAC) use, and the interval between template placement and definitive split-thickness skin grafting (STSG). Results: Integra was applied in 60.0% (n = 6) of cases and Matriderm in 40.0% (n = 4). Adjuvant VAC/NPWT therapy supported integration in 70.0% (n = 7) of cases. Among Integra-treated cases, the interval from template placement to definitive grafting ranged from 8 to 22 days. Across the cohort, the template integrated successfully in 8 of 10 cases (80.0%), while 2 cases (20.0%) did not achieve integration. Conclusion: Both Integra and Matriderm are effective scaffolds for converting complex defects into graftable wound beds. Integra suits extensive, high-risk defects requiring staged reconstruction, while Matriderm offers a faster route to definitive coverage in selected cases.