Pilot Study: DermiSphere: A Novel Hydrogel with Collagen Microspheres Dermal Regeneration Template.

BACKGROUND

Dermal regeneration templates (DRTs) have become an addition to the reconstructive ladder to treat various wound types. Recently, a novel hydrogel DRT (hDRT) combining a collagen-based hydrogel scaffold with embedded collagen microspheres (DermiSphere) has been introduced that permits rapid integration for early second-stage skin grafting.

METHODS

Four patients had DermiSphere hDRT applied to oncologic facial defects with plans for 2-stage reconstruction after definitive margin clearance. These defects consisted of 2 nasal, 1 forehead/glabellar, and 1 cheek. Applications involved single-layer versus 2-layer techniques followed by second-stage skin grafting.

RESULTS

This early pilot series indicated that DermiSphere hDRT provided for rapid vascularization to support early second-stage skin grafting. The primary defect sizes at time of hDRT application ranged from 2.1 × 2.2 cm (4.6 cm2) to 6 × 6 cm (36 cm2). Time to second-stage skin grafting ranged 7-18 days (average 11.5 d). In all applications of hDRT, the size and depth of the soft tissue defects were observed to have favorable wound contraction with a vascularized tissue bed prepared by application of the hDRT.

CONCLUSIONS

This pilot study showed rapid hDRT vascularization permitting successful skin grafting in a relatively condensed timeframe. Additionally, layering of the hDRT was possible without significant delay to definitive skin grafting. In 1 case, immediate skin grafting at the time of hDRT placement was able to be achieved. Although some degree of wound contraction occurred in all cases, this contraction resulted in limited distortion of the adjacent tissues with acceptable functional and aesthetic results that continued to improve over time.