Introduction: Upper extremity injuries can often be complex requiring soft tissue coverage. The mainstay for the coverage of full-thickness skin defects is autologous skin grafts (STSG). As a result, STSG provides unsatisfactory functional and cosmetic outcomes. To overcome these limitations, various and alternative methods have been attempted as alloplastic dermal substitutes.
The aim of the study is to present our short-term experiences with collagen and elastin dermal matrix - Matriderm in the management of full-thickness skin defects in the upper extremity. 
Material and Methods: Between August 2018 and February 2019, a retrospective review of patients with full-thickness skin defects in the functional region of the upper extremity was performed. All the patients were treated with the dermal substitute Matriderm with 1mm thickness, and unmeshed skin graft in a single-step procedure. We examined the efficacy and graft survival rate and evaluated postoperative functional skin values. Individual comparisons were performed between the area of skin graft and the surrounding normal skin. Early evaluation of the wounds took place on day 5 and 9, determining the take rate of the skin grafts in percentage. Their case notes were reviewed and data was collected - age, injury mechanism, site, and defect size.
Results: A total of 9 patients were enrolled in this study. The mean age was 34.5517.51 years. Causes of the defects included correction of scar contracture (n=4), degloving injury (n=3) and high-energy trauma (n=2). The size of soft tissue defects was between 120 and 300 cm2 (23579.37). There were no complications or inflammatory response in all cases but one, which resulted in a seroma. All wounds were epithelized within 11 days without additional grafting. The overall survival rate of the matrix and the skin graft was 97.552.60%. The average VSS was 1.97. 
Conclusion: Managing the upper extremity injuries is complex and requires careful planning to provide stable coverage by the safest and least invasive method. Matriderm represents a valuable alternative to other types of defect coverage and should be considered in the treatment of skin injuries.

4 - Management of full-thickness skin defects in the upper extremity: first short-term experiences with the acellular dermal substitute