[1]Wenzhou Medical College, Burn and Wound Healing Centre,Wenzhou,China
[2]National Engineering Research Center for Tissue Restoration and Reconstruction,Guangzhou,China
[3]Taihe Hospital, Hubei Medical College,,China
[4]Wenzhou Medical University, Department of Wounds and Burns Center,University Park,China
[5]The School of Wenzhou Medical University, Department of Clinical Medical Sciences,,China
[6]Fudan University Shanghai Medical College, Department of General Surgery,Shanghai,China
Objective The closure of chronic wounds after skull defect reconstruction with titanium mesh is one of the most challenging problems for plastic and reconstructive surgeons. Current approaches are disappointing. Methods In 10 patients, we explored the role of acellular dermal matrix (ADM) in combination with autologous skin grafts (ASGs) for closure of chronic wounds after skull reconstruction with titanium. Results ADM and ASG survived in all patients. Grade A healing (healing well without defect) was achieved. The average operating time was 30 to 45 minutes, and the average blood loss 30 to 50 mL. After 3 months, the wound was still closed in all patients. Conclusion The combination of ADM plus ASG obtained a high wound closure rate. ADM plus ASG allows avoiding other procedures such as rotational flaps and free flaps that require more operating time, special equipment, and adequate training. © 2016 Georg Thieme Verlag KG Stuttgart, New York.