Expedited infection control and wound healing by combining Matriderm^®, a dermal matrix, and Stimulan^® absorbable antibiotic beads: a case report

Background: Since dermal matrices (DMs) were first described in surgery, they have become an integral part of the reconstructive ladder, providing plastic surgeons with new approaches to wound reconstruction. While they have been used in reconstruction of a wide range of wounds, there has been limited or no literature on their effects when used in conjunction with fully absorbable antibiotic beads. Therefore, the aim of this study was to analyze the effects of using Matriderm^® dermal matrix concurrently with Stimulan^® absorbable antibiotic beads on wound healing and readiness for skin grafting.

Case description: In this manuscript, we report the case of an adult ethnic Chinese male patient with recalcitrant infected right lower limb fasciotomy wounds managed using Matriderm^® dermal matrix in conjunction with Stimulan^® absorbable antibiotic beads prior to split-thickness skin graft reconstruction. The patient was a non-smoker with no known comorbid medical conditions and had initially presented with right lower limb compartment syndrome and rhabdomyolysis following a fall with long lie. He subsequently underwent an emergency fasciotomy with resulting medial and lateral right lower limb fasciotomy wounds. In this case report, wound revascularization, granulation formation and readiness for skin grafting were observed after one week of concurrent application of Matriderm^® and Stimulan^®. The patient's post-operative recovery was uneventful and he was discharged eleven days post skin grafting. There was at least 97% graft uptake and the graft donor site had healed well and was left exposed.

Conclusions: The application of DMs in conjunction with absorbable antibiotic beads may shorten time to readiness for definitive wound coverage. Further randomized controlled trials are required to evaluate this potentially synergistic relationship.