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.
Munster
A M
AM
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
Smith-Meek
M
M
Shalom
A
A
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