Biological incorporation of human acellular dermal matrix used in Achilles tendon repair.

Human acellular dermal matrices (ADMs) are used successfully in a variety of procedures, including sports medicine related, wound repair, and breast reconstructions, but the mechanism of repair is still not fully understood. An opportunity to explore this mechanism presented itself when a patient experienced a rerupture of the native tendon due to a fall that occurred 2 months after undergoing an Achilles tendon repair using Matracell treated ADM. The ADM was removed and an extensive histology analysis was performed on the tissue. Additionally, a literature review was conducted to determine the mechanism of ADM integration into the tendon structure and explore if differences in this mechanism exist for different types of human ADMS. The histology analysis demonstrated that the healing process during a tendon reconstruction procedure is similar to that of wound healing. Furthermore, the literature review showed that differences exist in the mechanism for integration among various human ADMs and that these differences may be due to variances in the methods and technologies that manufactures use to process human ADMs.

Soft Tissue Enhancement and Implant Placement Following Partial Mandibulectomy Due to Squamous Cell Carcinoma.

Many dental procedures allow for implant placement in partially or totally edentulous patients. Despite the availability of various implant and abutment types on the market, it often becomes quite challenging to achieve the biological and esthetic goals in a patient who has ridge deficiencies. Problems arise from the lack of adequate bone quality and quantity. 1 , 2 Soft tissue form and maintenance is also a consideration to evaluate. 3 Primary reconstructive techniques following segmental mandibulectomy is evolving and improves quality of life. A seldom encountered complication is the discovery and treatment of a malignant process (for example, squamous cell carcinoma). Oral squamous cell carcinoma (OSCC) is one of the most aggressive malignancies worldwide and accounts for more than 90% of all oral cancers. 4 It is ranked as the sixth leading cause of cancer mortality worldwide. The most common sites of OSCC are the lateral ventral surface of the tongue, the floor of the mouth and buccal mucosa. For most oral cavity cancers, surgery is the initial treatment of choice (often involving the full or partial removal of bony jaw structure). 5 Radiation or chemoradiation is added postoperatively if disease is more advanced or has high-risk features. Successful cancer therapy can affect the quantity and quality of soft tissue in areas where implants are planned, thus affecting the initial placement and the long-term success of the implants. Complications can be numerous; especially difficult is implant treatment in the mandibular anterior area where inadequate alveolar height results in the lingual floor and the vestibule becoming contiguous. 6 Further complicating treatment is the presence of scar tissue (often found following cancer surgery and radiotherapy). The present case is a report of the combination of a soft tissue enhancement and implant placement following partial mandibulectomy resulting from the treatment of oral squamous cell carcinoma. A video abstract is available for viewing at https://youtu.be/dZ9t3j4ufOc?list=PLvRxNhB9EJqbqjcYMbwKbwi8Xpbb0YuHI .

Use of a novel acellular dermal matrix allograft to treat complex trauma wound: a case study.

OBJECTIVE: To report the novel use of acellular dermal matrix allograft to treat a complex open fracture of the arm. METHODS: Case report outlining the steps taken to treat the fracture and soft tissue trauma. RESULTS: The complexity of the wound required multiple types of treatments that ultimately resulted in a healed fracture and full wound closure. CONCLUSIONS: Acellular dermal matrix has shown promise in closing the wound of a complex open fracture within the limitations of a single patient case study.