Regenerative surgery for sacral pressure ulcers using collagen matrix substitute dermis (artificial dermis)

Collagen matrix substitute dermis, or artificial dermis, has recently been developed to induce angiogenesis and fibroplasia in deep, poorly vascularized tissue defects, and its use is desirable as a means of achieving effective treatment with less invasion. However, it is difficult to apply collagen matrix to pressure ulcers, because they are usually accompanied by infection with discharge of excessive amounts of exudate or pus and generally exposed to external forces that prevent graft fixation. To overcome these difficulties, the authors demonstrated a novel procedure to exclude unfavorable exudate and external forces. The procedure resulted in successful fixation of the artificial dermis and induction of regeneration in poorly vascularized defects in every case. The histologic findings provided supporting evidence that collagen matrix acts as a scaffold for reconstruction of nearly normal vascular structures coursing perpendicularly in the upper layer of normal dermis.