Evaluation of contraction of the split‐thickness skin graft using three dermal matrices in the treatment of burn contractures: A randomised clinical trial

Abstract

Burn injuries commonly result in serious sequelae (such as skin contractures) in surviving patients, for which no single optimal solution is known. The goal of this study was to compare the late contraction of autologous skin grafts with or without dermal matrices used in the treatment of patients with burn contractures. This parallel design prospective, randomised and controlled clinical trial included patients with burn contracture treated using autologous skin grafts and dermal matrix. Patients were randomly assigned to one of the four groups: Integra® matrix (n = 10), Pelnac® matrix (n = 10), Matriderm® matrix (n = 9) or a Control Group (n = 10, without dermal matrix, only skin graft). The boundaries of skin defect were marked and transferred to a flat sterile surface for area measurement. The current area of the skin grafts was measured during surgery and compared with those obtained at 1, 3, 6 and 12 months postoperatively. Twelve months after surgery, the Control Group presented lower rates of skin graft contraction than Integra® (p < 0.01), Matriderm® (p = 0.01) and Pelnac® (p < 0.01) groups. Pelnac® resulted in larger skin graft contraction than Matriderm® (p < 0.01) and Integra® (p = 0.02), while differences between Integra® and Matriderm® were not significant (p = 0.16). The comparison between intraoperative and 12 months after surgery showed that the worst mean rates of skin graft contraction were from the Pelnac® (51.79%) and Matriderm® (59.17%). In patients with burn contractures, the use of these three dermal matrices did not reduce or avoid the occurrence of late contraction of the skin graft, so their use for this purpose should be carefully evaluated.

Copper-Epigallocatechin Gallate Enhances Therapeutic Effects of 3D-Printed Dermal Scaffolds in Mitigating Diabetic Wound Scarring

“…Taking the size of the skin graft immediately after skin grafting as the initial area (100%), the wound size in the late healing period (56 days after operation) in group E/C was 90.76 ± 1.26%, indicating that there was no obvious contracture in rat skin after STSG transplantation. The healed wound in group PL within the late healing period was 53.60 ± 14.26%, suggesting that there was a severe contracture during the skin healing process, which was consistent with previous reports. , …”

“…The healed wound in group PL within the late healing period was 53.60 ± 14.26%, suggesting that there was a severe contracture during the skin healing process, which was consistent with previous reports. 45,46 Compared to foaming process-made Pelnac (i.e., its internal pores cannot be guaranteed to be fully connected), the 3Dprinted E/C dermal scaffolds prepared in our study had moderate mechanical strength and all connected internal pores. The tissue fluid flows through the scaffold in the early stage after skin grafting to provide nutrients for the upper skin.…”

Full Skin Equivalent Models for Simulation of Burn Wound Healing, Exploring Skin Regeneration and Cytokine Response

“…In this study, we generated FSEs from the dermal substitutes MatriDerm ® and Mucomaix ® . These dermal matrices are clinically used in combination with split thickness autografts to treat full-thickness skin defects and support skin regeneration [ 25 , 26 , 27 , 28 ]. Therefore, FSEs generated using these matrices are relevant in vitro study models.…”

Wound Healing after Acellular Dermal Substitute Positioning in Dermato-Oncological Surgery: A Prospective Comparative Study

“…Recently, a prospective randomized controlled clinical trial, including patients with burn contracture treated using autologous skin grafts and ADMs, was performed by Corrêa and collaborators [ 53 ]. Interestingly, the control group (patients treated with skin graft only, without previous ADM positioning) displayed lower rates of wound contraction.…”