Reduced wound contraction after grafting of full-thickness burns with a collagen and chondroitin-6-sulfate (GAG) dermal skin substitute and coverage with biobrane.
Full-thickness burns destroy both the epidermal and dermal tissues of the skin. This study evaluates a collagen and chondroitin-6-sulfate dermal skin substitute (graft) that was applied to excised full-thickness burns and covered with Biobrane. Experimental conditions included: (a) no burn, subcutaneous implantation of the graft; (b) burn, excision, graft, coverage with Biobrane and bandages; (c) burn, excision, no graft, coverage with Biobrane and bandages; (d) burn only. forty-one days post-surgery, subcutaneous implantation (N = 3) of the graft caused no detectable contraction or necrosis of the overlying skin, whereas all burn wounds contracted. Measurements of wounds (percentage of original wound size) showed statistically significant differences between the following treatments; (a) graft plus Biobrane (N = 10), 34%; (b) no graft plus Biobrane (N = 9), 25%; (c) untreated burns (N = 6), 16%. Semi-quantitative evaluation of time to healing indicated by spontaneous detachment of Biobrane from wounds showed that grafted, excised wounds healed in an average of 2.7 weeks, while ungrafted, excised wounds required an average of 4.3 weeks to heal. Histological appearance of healed wounds after grafting and coverage with Biobrane resembles undamaged skin without epidermal adnexal structures. Excision of full-thickness burn eschar, followed by grafting with a collagen and chondroitin-6-sulfate dermal skin substitute and coverage with Biobrane provides reduced wound contraction within a six-week period of observation compared to non-excised wounds. Both more rapid and more complete wound healing took place compared to excised wounds that were not grafted.
Boyce
S T
ST
University of California, San Diego Medical Center 92103.
Glafkides
M C
MC
Foreman
T J
TJ
Hansbrough
J F
JF
D000818:Animals; D001672:Biocompatible Materials; D002056:Burns / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D002807:Chondroitin / Q000031:analogs & derivatives; D002809:Chondroitin Sulfates; D020099:Coated Materials, Biocompatible; D003094:Collagen; D005260:Female; D051379:Mice; D009779:Occlusive Dressings; D016038:Skin Transplantation; D013997:Time Factors; D014945:Wound Healing
C042816:Biobrane; D001672:Biocompatible Materials; D020099:Coated Materials, Biocompatible; D002807:Chondroitin; D002809:Chondroitin Sulfates; D003094:Collagen