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. Author manuscript; available in PMC: 2014 Sep 9.
Published in final edited form as: Hand Clin. 2014 May;30(2):239–vii. doi: 10.1016/j.hcl.2014.02.001

Figure 1.

Figure 1

Showing reconstruction of an extensive avulsion injury of the upper extremity with dermal skin substitutes. The dermal matrix should be applied on a vascular bed after wound debridement and secured to wound edges (a-c). A sheet of single stage dermal matrix was applied to the wound and covered directly with a skin graft in one procedure (d). Complete take of the composite dermal substitute and skin graft 1 week after surgery (e), and good postoperative results at 2-year follow-up. However, when using a 2 staged dermal substitutes, place the regeneration template with the silicone side up. After 2-3 weeks the silicone layer is peeled off and covered with a skin graft (not shown in this image). (From Demiri E, Papaconstantinou A, Dioyssiou A et al. Reconstruction of skin avulsion injuries of the upper extremity with integra® dermal regeneration template and skin grafts in a single-stage procedure. Arch Orthop Traum Su. Epub Aug 2013; with permission.)