Polylactic Acid Dermal Matrices: A Novel Solution for Accelerating Wound Healing in Complex Soft Tissue Defects

Introduction: Complex soft tissue defects (CSTDs) represent a sig- nificant challenge in wound management due to substantial tissue loss, infection, poor vascularization, or anatomically difficult locations where primary closure, including skin grafts or flap coverage, is not feasible in a single step. These defects are most commonly caused by trauma but can also arise from infection, surgery, or tumour excision. This study evaluates the use of a novel polylactic acid (PLA) dermal matrix to treat CSTDs and facilitate wound closure. Methods: We present a cohort of 10 patients with CSTDs caused by trauma. Among them, 5 had open fractures, 2 had burns with deep partial and full-thickness injuries, 1 experienced soft tissue loss from a dog bite, and 2 presented with necrotizing fasciitis. All wounds underwent extensive debridement, fixation of hard tissues, and soft tissue repair in a two-stage process. A PLA dermal matrix was applied to promote the formation of a granulating tissue bed, followed by skin grafting within 14–21 days. Results: All cases achieved successful skin graft integration without complications, including infection, tissue loss, or mortality. Histological analysis demonstrated increased collagen deposition (Masson’s tri- chrome staining) and enhanced vascularization with increased CD31-pos- itive blood vessel density in the treated tissues. Applying the PLA matrix enabled rapid wound bed preparation, allowing for early grafting and patient discharge. Discussion: The use of PLA dermal matrices is an effective strategy for managing CSTDs. This approach accelerates wound bed preparation, facilitates successful skin grafting, and shortens hospital length of stay. These features suggest that PLA matrices offer a cost-effective solution for treating complex soft tissue defects, improving patient outcomes, and reducing healthcare burden. Further studies are warranted to validate these findings in larger cohorts.