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Objectives and questions: Full thickness traumatic soft tissue defects are difficult to treat. Mesh graft transplantation alone causes frequently instable scar ulcerations with need for revision surgery. For that reason, in our study we used a collagen-elastin scaffold combined with mesh graft to improve wound healing and to reduce scar ulcerations and revision surgery.

Material and methods: In the period 3.2013 – 3.2020 45 trauma wounds from different types of injuries were treated with a collagen-elastin scaffold (Matriderm^®, MD) augmented mesh graft. The wounds were separated in three subgroups (soft tissue injury (ST), closed fracture with soft tissue injury (F), open fracture (OF). Outcome variables were recurrence of wound defects with revision surgery and reduction of bacterial strains. For statistical analysis Student’s t-test, ANOVA, Mann-Whitney U test, and Pearson’s chi-squared test was used.

Results: For the rate of recurrence there was no significant difference between the three groups (F: 0%; OF: 11.1%; ST: 9.5%). The duration of VAC/NPWT therapy for preconditioning the wounds, significantly differed between the groups (F: 10.8 days; OF 22.7 days; ST: 12.6 days (p<0.05)). With NPWT a clinically significant reduction of bacterial burden was achieved (bacterial shift (mean (SD), F: -2.25 (1.89); OF: -1.9 (1.37); ST:-2.6 (2.2)).

Discussion and conclusions: For the rate of recurrence there was no significant difference between the three groups (F: 0%; OF: 11.1%; ST: 9.5%). The duration of VAC / NPWT therapy for preconditioning the wounds, significantly differed between the groups (F: 10.8 days; OF 22.7 days; ST: 12.6 days (p<0.05)). With NPWT a clinically significant reduction of bacterial burden was achieved (bacterial shift (mean (SD), F: -2.25 (1.89); OF: -1.9 (1.37); ST:-2.6 (2.2)).