The use of the acellular dermal matrix in microtia reconstruction to decrease donor site morbidity after temporo-parietal fascia harvest

IF 2.5 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery Pub Date : 2026-05-01 Epub Date: 2025-10-30 DOI:10.1016/j.jpedsurg.2025.162753

Maria Ida Rizzo , Jacopo Maria Frattaroli , Francesca Nascimben , Marco Cirillo , Marta Umbaca , Marta Cajozzo , Gaetano Paolo Dicorato , Francesca Grussu , Rossella Angotti , Simone Faustino Marino , Francesco Molinaro , Giorgio Spuntarelli , Urbano Urbani , Mario Zama

{"title":"The use of the acellular dermal matrix in microtia reconstruction to decrease donor site morbidity after temporo-parietal fascia harvest","authors":"Maria Ida Rizzo , Jacopo Maria Frattaroli , Francesca Nascimben , Marco Cirillo , Marta Umbaca , Marta Cajozzo , Gaetano Paolo Dicorato , Francesca Grussu , Rossella Angotti , Simone Faustino Marino , Francesco Molinaro , Giorgio Spuntarelli , Urbano Urbani , Mario Zama","doi":"10.1016/j.jpedsurg.2025.162753","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To determine whether and how the use of an acellular dermal matrix (ADM) underneath a scalp flap after temporal fascia harvest reduces postoperative donor-site complications in microtia surgery.</div></div><div><h3>Methods</h3><div>This case‒control study included patients with congenital microtia who underwent primary ear reconstruction with porous polyethylene implants between 2018 and 2021. Group No-ADM patients (2018–2019), Group ADM patients (2020–2021). The skin quality outcomes of the scalp flap after temporal fascia harvest were analysed through pinch tests and ultrasound imaging. Aesthetical and psychosocial outcomes were tested with standardized questionnaires that were administered to the patients and their parents.</div></div><div><h3>Results</h3><div>20 patients (60 % male), 8 (40 %) in the No-ADM group and 12 (60 %) in the ADM group. Re-do surgery rate was higher in the No-ADM group than in the ADM group (17.5 % vs 5 %; p < 0.05). The pinch test was used to assess the recovery of tissue elasticity in the 100 % ADM group, and it was negative in the 75 % No-ADM group (p < 0.05). The median US thickness was 4.87 mm in the No-ADM group and 4.48 mm in the ADM group (p = 0.37). Aesthetic analysis revealed higher satisfaction levels among patients in the ADM group than in those in the non-ADM group. There was no significant difference in terms of quality of life between the two groups.</div></div><div><h3>Conclusions</h3><div>ADM use decreases local morbidity after facial harvest in the temporoparietal region. The greater thickness of the skin in the No-ADM group despite the absence of the ADM was probably due to greater fibrogenesis, which was limited by the ADM in the ADM group. In conclusion, ADM reduces the risk of postoperative subcutaneous scar adhesions.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"61 5","pages":"Article 162753"},"PeriodicalIF":2.5000,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of pediatric surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022346825006001","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/10/30 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

To determine whether and how the use of an acellular dermal matrix (ADM) underneath a scalp flap after temporal fascia harvest reduces postoperative donor-site complications in microtia surgery.

Methods

This case‒control study included patients with congenital microtia who underwent primary ear reconstruction with porous polyethylene implants between 2018 and 2021. Group No-ADM patients (2018–2019), Group ADM patients (2020–2021). The skin quality outcomes of the scalp flap after temporal fascia harvest were analysed through pinch tests and ultrasound imaging. Aesthetical and psychosocial outcomes were tested with standardized questionnaires that were administered to the patients and their parents.

Results

20 patients (60 % male), 8 (40 %) in the No-ADM group and 12 (60 %) in the ADM group. Re-do surgery rate was higher in the No-ADM group than in the ADM group (17.5 % vs 5 %; p < 0.05). The pinch test was used to assess the recovery of tissue elasticity in the 100 % ADM group, and it was negative in the 75 % No-ADM group (p < 0.05). The median US thickness was 4.87 mm in the No-ADM group and 4.48 mm in the ADM group (p = 0.37). Aesthetic analysis revealed higher satisfaction levels among patients in the ADM group than in those in the non-ADM group. There was no significant difference in terms of quality of life between the two groups.

Conclusions

ADM use decreases local morbidity after facial harvest in the temporoparietal region. The greater thickness of the skin in the No-ADM group despite the absence of the ADM was probably due to greater fibrogenesis, which was limited by the ADM in the ADM group. In conclusion, ADM reduces the risk of postoperative subcutaneous scar adhesions.

查看原文本刊更多论文

使用脱细胞真皮基质进行小腹重建以减少颞顶筋膜摘取后供区发病率。

目的：探讨颞筋膜摘取后在头皮瓣下应用脱细胞真皮基质（ADM）是否以及如何减少微创手术后供区并发症。方法：本病例对照研究纳入了2018年至2021年间采用多孔聚乙烯种植体进行初级耳部再造术的先天性小耳症患者。No-ADM组患者（2018-2019），ADM组患者（2020-2021）。通过捏片试验和超声显像分析颞筋膜切除后头皮皮瓣的皮肤质量。审美和心理社会结果通过标准化问卷进行测试，这些问卷发给了患者和他们的父母。结果：20例（男性占60%），No-ADM组8例（40%），ADM组12例（60%）。No-ADM组的重做率高于ADM组（17.5% vs 5%）。结论：ADM的使用降低了颞顶区面部切除术后的局部发病率。在没有ADM的情况下，No-ADM组的皮肤厚度更大，这可能是由于更多的纤维形成，而ADM组的纤维形成受到ADM的限制。总之，ADM降低了术后皮下瘢痕粘连的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of pediatric surgery 医学-外科

CiteScore

1.10

自引率

12.50%

发文量

569

审稿时长

38 days

期刊介绍： The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.