New frontiers of dermal repair and regeneration for a modern approach in wound healing

Background: Dermal restore is a crucial phase in acute and in chronic wound healing and it represents a field of innovative research. The choice of the dermal substitute is a key moment in the wound regenerative process. The aim of the study was to analyze the performance of different products and their impact on the healing process. Methods: Patients with wounds treated with different dermal matrices were enrolled from August 2021 to August 2023 in the Plastic and Reconstructive Surgery Department of Trieste. Among the data analyzed, we included demographic and clinical data, type of dermal substitute and its performance. Results: We enrolled 84 patients who underwent dermal substitute application on acute and chronic wounds of different etiologies. From the analysis of the cases treated low rate of complications appeared. The most frequent were infection and failed engraftment. Conclusions: Permanent substitutes created a valid tissue to support the healing process. They provide granulation tissue or neodermis, both useful for the skin graft taking, while bioinductive matrices provide the formation of granulation tissue. In this work, we share our experience with different substitutes, and we suggest indications tailored on patients’ clinical conditions.