The Use of Acellular Dermal Regeneration Template Associated with Decreased Admissions for Surgical Site Infections
Introduction: There are various biologic and synthetic tissues available to aid in wound healing. Acellular Dermal Regeneration Template (ADRT)* is a two-layered skin repair product. The bottom layer is made of bovine collagen and chondroitin, while the top is a thin silicone layer.
Purpose: We did a retrospective analysis to evaluate the relationship between admissions for surgical site infections and the use of ADRT.
Methods: Various Current Procedural Terminology (CPT) codes were used to identify 256 unique patients with treated for lower extremity wounds that were cared for by a Vascular Surgery Service at a large inner city tertiary care wound program from 2016-2018. Chart review was performed on each patient to collect data on the management of their wounds. Logistic regression analysis was performed with admission due to the surgical site infection after operative debridement and/or placement of a skin substitute.
Results: Out of the 256 patients reviewed, 244 patients were included in this analysis due to missing data points in the rest. Out of these, 43 patients were identified as requiring subsequent admission for a surgical site infection after they had an operative debridement and/or dermal matrix. Logistic regression analysis found that the use of ADRT was associated a statistically significant decrease in admissions for surgical site infections (p<0.02, OR 0.249, CI 0.082-0.751).
Conclusion: Based on our retrospective analysis, we found that the use of ADRT was associated with decreased admissions for surgical site infections. Confounding variables include different surgeon preferences on product choice, any underlying differences in chronic medical condition between patients who received ADRT, other dermal matrices, or just debridement. Further analysis will be performed to elucidate and potentially correct for any confounding variables.
*Integra® Dermal Regeneration Template
