Evaluation of Clinical and Biomechanical Features of Scars Resulting from the Treatment of Burn Contractures Comparing Acellular Dermal Matrices

Abstract

The aim of this study was to compare clinical and biomechanical features of scars resulting from the treatment of burn contractures using different acellular dermal matrices (ADM). Summary Background Data: Extensive burns often lead to severe sequelae, such as skin contractures, that can be treated using ADM to improve the quality of these scars. Methods: A prospective, randomized and controlled clinical trial was performed including patients with burn contractures at least 1-year postburn, treated using split-thickness skin graft (STSG). These patients were randomized into 4 groups: control (received only STSG without ADM), Integra (ADM + STSG), Matriderm (ADM + STSG), and Pelnac (ADM + STSG). Exclusion criteria were loss of follow-up and graft integration failure. The evaluation was performed using the Vancouver Scar Scale (VSS), the durom-eter, and the cutometer in areas of normal skin, hypertrophic scar, and surgical scar, at least 1 year after the surgery. Results: In the VSS, durometer, and cutometer evaluation, there was no difference in the comparison of surgical scars among groups. Analyzing each group, with an intraindividual evaluation comparing areas of normal skin with surgical scars, the results suggested a possibility of a surgical scar hardness closer to normal skin for Integra and Matriderm groups measured with the durometer. In the cutometer evaluation, surgical scars were not comparable to areas of normal skin. Conclusions: This study suggests that there is no difference in the quality of scar assessed through the analysis of clinical and biomechanical features comparing acellular dermal matrices (Integra, Matriderm, and Pelnac) and only split-thickness skin graft without a dermal matrix.

Multicenter effect analysis of one‐step acellular dermis combined with autologous ultra‐thin split thickness skin composite transplantation in treating burn and traumatic wounds

“…ADM can be divided into allogeneic ADM (humanoid) and heterogeneous ADM (animal‐born) according to material source. The main source of allogeneic ADM is made from donated allogeneic dermis, which retains the extracellular matrix, collagen and proteoglycans in the dermis, 12,13 its biocompatibility is high and the incidence of immune rejection is extremely low; the main source of xenogenic ADM is soft tissue from pigs and cattle, 14 although its structure is similar to that of allogeneic ADM, the inflammatory response after xeno‐ADM transplantation is greater than that of allogeneic ADM due to the large differences in the molecular structure of the histocompatibility complex between donors and receptors and the composition of the basement membrane. Studies have found that scar growth is obvious during the healing process if the wound lacks the dermis layer, and studies have also shown that the lack of elastic fibres and collagen arrangement disorder is the most important histological features of scar tissue 15 .…”

Application of Acellular Dermal Matrix in Gynaecology—A Current Review

“…These treatments include, among others, burn treatments, hernia repair, breast reconstruction, etc. [ 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]. Moreover, there are several reports on the use of ADMs in gynaecological reconstructive surgery [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ].…”

Application of a meshed artificial dermal scaffold and negative-pressure wound therapy in the treatment of full-thickness skin defects: a prospective in vivo study

“…A longer research period may be planned for our future work. Another limitation of our study was the lack of surgical scar assessment, such as the Vancouver Scar Scale (VSS) and durometer and cutometer evaluation, 44 which would help to support the research conclusions. These scar assessments would certainly be carried out in our future work.…”