Acellular allograft dermal matrix: immediate or delayed epidermal coverage?
In a prospective, randomized study seventeen patients received skin grafts to a freshly excised burn wound. One group was grafted with a deantigenized dermal matrix and immediately overgrafted with thin autograft. The second group was grafted with dermal matrix, which was then covered with bank allograft for protection, and autografted 1 week later. Each group also received a standard split thickness control graft. Assessment was carried out for up to 1 year. There were no statistically significant differences of graft take between any of the groups, or in the Vancouver scar score at follow-up. Thin donor sites used for dermal matrix coverage healed faster than standard control graft sites, P<0.001. Immediate grafting of acellular dermal matrix with thin autograft works well and leads to an acceptable late result, with faster donor site healing than standard split thickness grafts.
Baltimore Regional Burn Center, Johns Hopkins Bayview Medical Center and the Department of Surgery, Johns Hopkins University, 4940, Eastern Avenue, Baltimore, MD 21224, USA. amunster@jhmi.edu
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Munster
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Smith-Meek
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Shalom
D000328:Adult; D000368:Aged; D002056:Burns / Q000175:diagnosis / Q000601:surgery*; D003131:Combined Modality Therapy; D000078404:Epidermal Cells; D004817:Epidermis / Q000637:transplantation*; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D015601:Injury Severity Score; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D016038:Skin Transplantation / Q000379:methods*; D013526:Surgical Mesh; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology