INTRODUCTION: The standard care for these lower extremity injuries with exposed bone is vascularized tissue transfer; however, this option is often not available or is technically difficult. The advent of Dermal Regeneration Template, a bioengineered skin substitute, provides a remarkable alternative to the traditional reconstructive choices. CASES REPORT: The authors report two patients from a total of 246 patients who had burns involving their lower extremities, admitted to S. José Hospital Burn Unit, between January 2007 and December 2008. Both patients had bilateral deep burn injuries with exposed bone affecting the anterior surface of lower leg and were treated with tangential excision of the burn eschar and placement of the Dermal Regeneration Template. Four weeks later, after engraftment of the matrix, the thin outer layer of silicone was removed and the epidermal coverage was restored with a split thin skin graft. Stable wound cover was achieved and no further surgical procedures were required to maintain wound closure. CONCLUSION: The use of a dermal replacement matrix expands reconstructive options for difficult burn (and non burn) wounds, preventing prolonged, staged procedures, allowing successful coverage of vital structures without the use of a flap and, as in these particular cases, the salvage of the extremity.
Burns; Lower extremity; Reconstruction; Leg
