A novel dermal matrix generated from burned skin as a promising substitute for deep-degree burns therapy

Abstract

The extensive skin defects induced by severe burns are dangerous and can be fatal. Currently, the most common therapy is tangential excision to remove the necrotic or denatured areas of skin, followed by skin grafting. Xenogeneic dermal substitutes, such as porcine acellular dermal matrix (ADM), are typically used to cover the burn wounds, and may accelerate wound healing. It is assumed that burned skin that still maintains partial biological activity may be recycled to construct an autologous acellular dermal matrix, termed 'deep-degree burned dermal matrix (DDBDM)'. In theory, DDBDM may avoid the histoincompatibility issues associated with foreign or xenogeneic dermal matrices, and reduce therapy costs by making full use of discarded skin. In the present study, the collagens within prepared DDBDM were thickened, disorganized and partially fractured, however, they still maintained their reticular structure and tensile strength (P<0.01). Through microarray analysis of the cytokines present in ADM and DDBDM, it was determined that the DDBDM did not produce excessive levels of harmful burn toxins. Following 4 weeks of subcutaneous implantation, ADM and DDBDM were incompletely degraded and maintained good integrity. No significant inflammatory reaction or rejection were observed, which indicated that ADM and DDBDM have good histocompatibility. Therefore, DDBDM may be a useful material for the treatment of deep-degree burns.

Effect of TNF-α concentration on selected clinical parameters of swine after burns

“…(14) showed the correlation between the dynamics of TNF-α concentration increase and the extent of the burn, however, these results have not been confirmed by other authors (22). The majority of the authors agree that the TNF-α concentration increases after a burn injury, although some state that the concentration of TNF-α in human burn patients does not differ from the concentration in the control group, or is only marginally higher (approximately 1.5– 2.5 times) in the post-burn period (10, 12). In burned patients, TNF-α serum concentration is low and increases 5-fold only during the first week after the burn (10).…”

“…There is no data in the literature on simultaneous and associated changes in TNF-α concentration and basic clinical parameters (body temperature, pulse, and respiration rate) in swine after II and III degree burns. In burn studies, in vivo models are still irreplaceable and necessary to elucidate the mechanisms of burn healing on a cellular and molecular level and to develop new treatment strategies (12, 27). Among many possible animal models, the domestic swine is the most appropriate one for conducting burn disease studies.…”

Decellularized Scaffolds for Skin Repair and Regeneration

“…Although human ADMs and engineered human skin matrices have shown satisfactory effects in the treatment of extended second-and/or third-degree burns when xenogeneic ADMs lack histocompatibility, human ADMs are so expensive that their use is often impossible in these indications. The necessity of novel cost-effective dermal substitutes with equivalent efficiency has led to the search for alternative solutions [45]. The critical barrier to xenogeneic scaffolds in translational application is the recipient immune response to the antigenic components of the xenogeneic tissue [46].…”

Current knowledge of immunomodulation strategies for chronic skin wound repair

“…It is an ideal choice for bonding with other biomaterials or a suitable carrier for the release of biological agents due to its flexibility properties 200,201 . On the other hand, immunomodulation studies showed gelatin affects the progression of inflammation with increasing cytokine release 202 . Recently, Zhao et al 203 investigated the effects of gelatin on the skin cancer cell and immunomodulation pathway.…”