Pilot Study: Soft-tissue Healing After Augmented Closure of Traumatic Injuries With Synthetic Electrospun Fiber Matrix

Background: Primary closure of traumatic musculoskeletal soft-tissue wounds is often complicated by soft-tissue edema or compromised skin integrity. Tenuous primary skin closure is associated with an increased incidence of major wound complications. The aim of this retrospective case series was to evaluate soft-tissue healing outcomes following incorporation of a synthetic electrospun fiber matrix (SEFM) to provide soft-tissue reinforcement of primary surgical closure of musculoskeletal injuries. Methods: A retrospective medical record review of patients treated at a single trauma site for musculoskeletal injuries requiring surgical intervention was conducted following local institutional review board exemption. Subjects who underwent orthopedic reconstruction with subdermal SEFM placement during primary closure were included. Subject data were collected from surgical intervention with SEFM until the final postoperative follow-up with the surgeon. Data regarding unplanned reoperation, infection, major dehiscence, and time to complete incisional healing were collected and analyzed. Results: Nineteen subjects were identified and included in the analysis. The most common injury cause was open fractures (n = 11), with most injuries occurring in the lower extremity (n = 14). The most common reason for SEFM incorporation during primary closure was to offload tension at the suture line (n = 10). All injuries achieved successful surgical wound healing. The rate of complications requiring reoperation was 1 of 19 patients. Conclusions: Subdermal SEFM incorporation during primary closure resulted in complete soft tissue healing and low rates of major complications. This pilot study indicated that SEFM may be used to achieve primary closure and avoid advanced reconstructive procedures.