Long‐Term Followup of Dermal Substitution with Acellular Dermal Implant in Burns and Postburn Scar Corrections

Abstract

Full-thickness burn and other types of deep skin loss will result in scar formation. For at least partial replacement of the lost dermal layer, there are several options to use biotechnologically derived extracellular matrix components or tissue scaffolds of cadaver skin origin. In a survey, we have collected data on 18 pts who have previously received acellular dermal implant Alloderm. The age of these patients at the injury varied between 16 months and 84 years. The average area of the implants was 185 cm2. Among those, 15 implant sites of 14 patients were assessed at an average of 50 months after surgery. The scar function was assessed by using the modified Vancouver Scar Scale. We have found that the overall scar quality and function was significantly better over the implanted areas than over the surrounding skin. Also these areas received a better score for scar height and pliability. Our findings suggest that acellular dermal implants are especially useful tools in the treatment of full-thickness burns as well as postburn scar contractures.

Retrospective analysis of 56 soft tissue defects treated with one‐stage reconstruction using dermal skin substitutes

“…Functional and aesthetic outcomes are promising in patients with deep skin defects after tumor surgery, after pediatric surgery, as well as after two‐stage treatment of burn injuries . The resulting soft neodermis has shown improved scar elasticity and patient satisfaction . However, commercially available dermal substitutes show significant differences in matrix absorption, integration, early wound retraction, and scar contraction .…”

“…In general, it is imperative that wounds be free of infection prior to implantation of a collagen matrix. The microbial burden as well as infection‐related disturbances of microcirculation may inhibit graft take . In keeping with this requirement, we used Matriderm ® matrix in seven (25.5 %) patients only after local wound infections had been successfully treated.…”

The Use of Matriderm and Autologous Skin Graft in the Treatment of Full Thickness Skin Defects

“…To complement the drawbacks of STSG, various alternative dermal substitutes, such as acellular dermis or artificial dermal matrix, have been developed and have been applied in the treatment of full-thickness skin defects [3,6,7,8]. …”

Scarring vs. functional healing: Matrix-based strategies to regulate tissue repair

“…Decellularized tissues have also aided in the repair of critically sized skin defects. Alloderm ® has been shown to increase skin flexibility and improve scar quality in full-thickness wounds [143] while Oasis ® has facilitated complete healing in 60% of patients with chronic leg ulcers compared to 35% with the standard treatment [144]. Various decellularized dermis mesh materials are increasingly used in breast reconstructive procedures [145, 146], and Alloderm ® has also been used to facilitate frozen-banked ovarian tissue transplantation in the first reported pregnancies and live birth using this technique [147].…”