The use of a bilaminate artificial skin substitute (IntegraTM) in acute resurfacing of burns: an early experience

Fitton, A. R.; Drew, Peter; Dickson, W.A.

doi:10.1054/bjps.2000.3525

Cited by 60 publications

(29 citation statements)

References 22 publications

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“…[56][57][58] Integra Bilayer Matrix Wound Dressing is a synthetic bilayer acellular skin substitute composed of an outer silastic sheet (epidermal analogue) with a matrix composed of bovine collagen and glycosaminoglycan (dermal analogue). [59][60][61][62][63][64][65][66][67] The silastic sheet provides temporary cover before skin grafting is performed.…”

Section: Types Of Skin Substitutesmentioning

confidence: 99%

From Basic Wound Healing to Modern Skin Engineering

Andersson¹,

Nettelblad²,

Kratz

2009

Artificial Organs

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Section: Types Of Skin Substitutesmentioning

confidence: 99%

From Basic Wound Healing to Modern Skin Engineering

Andersson¹,

Nettelblad²,

Kratz

2009

Artificial Organs

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“…There are reports on the use of Integra in reconstructive surgery. 33,34 Reported disadvantages include the requirement for a second operation, the risk of infection beneath the silastic layer, the silicone becoming detached, and problems with contraction. Integra's advantages are its immediate availability in large quantities, the simplicity and reliability of its use and the functional and cosmetic properties of the resulting cover.…”

Section: Promogranmentioning

confidence: 99%

Wound Dressings Update

Weller

Sussman

2006

Pharmacy Practice and Res

113

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The availability of different types of wound dressings has increased in the last decade. Wound care practitioners have at their disposal an extensive range of dressings. Emerging dressing types include interactive/bioactive dressings and tissue-engineered skin substitutes. There is no one dressing that is suitable for the management of all types of chronic wounds and few are suited for the treatment of a single wound during all stages of the healing cycle. Successful wound management depends on an understanding of the healing process combined with knowledge of the properties of the various dressings available. Without such knowledge and careful assessment of all the factors that effect healing, dressing selection is likely to be arbitrary and ineffective, wasteful both in terms of time and physical resources. This article is an overview of some of the first-line and second-line interactive/bioactive dressings available. A synopsis of wound assessment and wound bed preparation will aid in choosing the appropriate dressings. It will also touch on advanced technologies including tissue-engineered skin substitutes. INTRODUCTIONNormal wound healing processes require restoration of epithelialisation and collagen formation. The first occurs by migration and proliferation of keratinocytes from the wound edges and by differentiation of stem cells from remaining hair follicle bulbs. The second occurs by influx of growth factors secreted by macrophages, platelets and fibroblasts, by fibroblast proliferation and subsequent synthesis and remodelling of collagenous dermal matrix. However, in the case of full-thickness burn injuries and chronic wounds such as pressure ulcers, venous ulcers and diabetic foot ulcers these processes are damaged and new technologies have been developed to improve the healing in these conditions. 1 The time it takes for a chronic wound to heal varies due to the idiosyncratic nature of each wound and inherent complex factors, which may impede healing. Infection, poor blood supply, immobility, diabetes, medicines, inadequate hydration and nutrition, trauma and poor wound management are causative or contributory factors. Tissue repair research and advances in moist wound healing pharmaceuticals have been pivotal in improving wound dressing technology. 2 Clinical experience suggests that wound healing is often impaired in the elderly. The elderly have a high prevalence of chronic leg and pressure ulcers and are vulnerable to skin tears that can be slow to heal due to decreased dermal thickness and the loss of proliferative capacity of the ageing dermis. 3 Chronic wounds represent a significant burden in human and economic costs. 4

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“…Entgegen der meisten bisherigen Studien [3,4,6,13] beobachteten wir bei einem Teil unserer Patienten eine leichte (12/19 Lokalisationen), vereinzelt aber auch eine ausgeprägte primäre (3/29) oder sekundäre (2/29) Tendenz zur Narbenkontraktion. Verglichen mit der Häufigkeit solcher Kontrakturen im Rahmen rekonstruktiver, Integra -basierter Eingriffe bei Erwachsenen, die in einer Studie von Hunt et al mit über 50 % angegeben wird, sind die hier erzielten Ergebnisse deutlich positiver [8].…”

Section: Diskussionunclassified

Integra® jenseits des akuten Verbrennungstraumas im Kindesalter - Erfahrungen aus 5 Jahren -

Spacek¹,

Jester²,

Schmedding³

et al. 2002

Zentralbl für Kinderchir

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ZusammenfassungZwischen 1996 und 2001 behandelten wir 22 Patienten im Alter von 2 Tagen bis 17 Jahren mit Integra Dermal Regeneration Template an insgesamt 29 Lokalisationen. Nach guten Erfahrungen in der Akutversorgung groûflächiger thermischer Verletzungen waren es neben Decollements und kongenitalen Hautdefekten vor allem rekonstruktive Eingriffe bei Narbenkontrakturen und -hypertrophien, bei denen das Material zum Einsatz gelangte, um Vollhauttransplantationen zu vermeiden. Das häufigste Anwendungsgebiet waren die Extremitäten der Patienten bei einer durchschnittlichen Gröûe chirurgischer Hautdefekte von ca. 60 cm 2 . Die Take-Rate von Integra betrug bei 24 der 29 Defekte 100 %. In 4 Fällen kam es zu Teilverlusten von 10±20 % und nur in einem Fall zu einem vollständigen Materialverlust bei problematischer Lokalisation des Defektes am Gesäû. In diesen Fällen war die Spalthauttransplantation dennoch erfolgreich möglich. Generell heilte die transplantierte Spalthaut zu über 90 % komplikationslos ein. Im Mittel vergingen 26 Tage vom Zeitpunkt der Rekonstruktion bis zur vollständigen Einheilung der Transplantate. Die Patienten wurden 3 bis 30 Monate nachbeobachtet. Im Verlauf zeigte nur ein Patient mit extremer Neigung zu Narbenhypertrophien eine erneute hypertrophe Narbenbildung im mit Integra rekonstruierten Bereich. Bei 12 von 29 behandelten Lokalisationen sahen wir eine leichte, in zwei Fällen eine starke sekundäre Schrumpfung der Narbe, während sich in drei Fällen bereits früh postoperativ keine Verbesserung gegenüber dem Vorbefund offenbarte. Damit profitierte die Mehrzahl der Patienten an insgesamt 82,8 % der behandelten Lokalisationen durch deutlich verbesserte Kosmetik und uneingeschränkte Funktion. Sowohl die Höhe der Behandlungskosten als auch die Dauer der stationären Behandlung waren nicht unerheblich, sodass die Indikation und das Handling für Integra bei Kindern sorgsam kritisch zu betrachten sind. SummaryFrom 1996 to 2001 22 patients between 2 days and 17 years of age were treated with Integra Dermal Regeneration Template at 29 various locations of the body. With the experience of good results in the early treatment of burns we focused on the use of Integra in paediatric reconstructive surgery for scar contractures and surgical full thickness skin defects. The most frequent region of application were the extremities. The average size of surgical defects was about 60 cm 2 . The take-rate of Integra was 100 % in 24 out of 29 defects. In 4 cases we observed a partial loss of Integra of about 10±20 %, and in only one case a total loss of the material due to its difficult location. However, this did not interfere with subsequent cover with split thickness skin grafts. In over 90 % of locations the transplanted mesh-graft healed without complications. On an average 26 days passed from the moment of reconstruction with Integra until full recovery of the split thickness skin graft. The patients were observed between 3 to 30 months. During this period we evaluated the tendency for secondary scar contraction...

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The use of a bilaminate artificial skin substitute (IntegraTM) in acute resurfacing of burns: an early experience

Cited by 60 publications

References 22 publications

From Basic Wound Healing to Modern Skin Engineering

From Basic Wound Healing to Modern Skin Engineering

Wound Dressings Update

Integra® jenseits des akuten Verbrennungstraumas im Kindesalter - Erfahrungen aus 5 Jahren -

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