Soft Tissue Reconstruction With Synthetic Electrospun Fiber Matrix Following Musculoskeletal Injury: A Retrospective Case Series.

Background: Restoration of a stable and functional soft tissue envelope following traumatic injury to the musculoskeletal system is critical. Where primary closure is not feasible, other reconstructive options must be considered to achieve soft tissue coverage of critical structures. Skin substitutes have been utilized to stimulate granulation tissue and support incorporation of autografts. This present study aims to investigate the use of a fully synthetic electrospun fiber matrix (SEFM) (Restrata; Acera Surgical, Inc) in the management of post-traumatic soft tissue defects. The objective of the present retrospective case series was to assess healing outcomes, including time to healing and incidence of complications, following a single application of the SEFM to soft tissue trauma surrounding musculoskeletal injury. Methods: Medical charts of patients with soft tissue injury secondary to musculoskeletal trauma and who were treated with the SEFM in the operating room following bony instrumentation or fasciotomy procedures were retrospectively reviewed following institutional review board approval. Included patients were treated with the SEFM in conjunction with negative pressure wound therapy as a means of preparing open wounds for definitive management via split-thickness skin grafting or secondary intention healing. Results: Eleven patients met the inclusion criteria. Injury etiologies included 8 open fractures in both upper and lower extremities, 2 open foot-crush injuries, and 1 incidence of forearm compartment syndrome. Ten patients achieved complete healing with minimal complications. Conclusions: Preliminary results indicate that the SEFM may be a viable adjunctive treatment for open post-traumatic wound beds to promote granulation tissue for definitive closure.