Integra® and Matriderm® dermal substitute: could personal medical history and lesion characteristics influence corrective surgery adverse outcome?

Background: In literature, there are no guidelines to identify which dermal matrix should be chosen and should be used in different cases. The aim of our study was to evaluate if there are any patient personal characteristics that could influence the success of the corrective surgery with Integra® and Matriderm® dermal matrices and the wound healing process. Methods: We conducted a retrospective analytical single-center clinical study. The sample involves 113 patients treated with dermal matrix positioning surgery from the pool of the Plastic Surgery Department of the “Spedali Civili” of Brescia between January 2015 and March 2021. Our study evaluated the success of treatment, the scarring result, and the type of dermal matrix used, taking into account all the possible influencing factors. Results: Taking into account the type of matrix used, significant differences in diagnosis (p = 0.002) and lesion site (p = 0.029) were found. By means of multivariate analysis, the presence of central nervous system (CNS) pathology appeared to be an independent, statistically significant factor which increased 4 times the risk of surgery failure and 11 times the incidence of non-optimal scarring. In the Integra® group, the presence of chronic diseases incremented the risk of intervention failure by fivefold. CNS diseases resulted independent risk factors respectively for surgery failure (increased risk of 16) and non-optimal scarring (increased risk of 21) in the Matriderm® group. Even with no statistical significance, Integra® and Matriderm® also showed different trends considering diagnosis and site of the lesion treated. Conclusions: Occurrence of complications during wound healing should be prevented and avoided in order to achieve the best result in corrective surgeries. The presence of chronic diseases is an influencing factor for the success of treatment, regardless of the type of dermal substitute used. Pathologies affecting the CNS turned out to be one of the most significant factors considered. Type and lesion sites could also take part in the failure of corrective surgery with dermal matrices and/or non-optimal scarring. Level of evidence: Level III, risk/prognostic.