title: The use of MatriDerm in early excision and simultaneous autologous skin grafting in burns--a pilot study.
abstract: The application of dermal substitutes in deep partial and full-thickness burn wounds in a two-stage procedure prior to skin grafting has become increasingly popular. Synchronous application of dermal substitutes and skin graft has not yet been established as a standard procedure. In a consecutive study 20 wounds in 10 patients with severe burns (age 49.5+/-16.2 years; TBSA 45.6+/-14.5%) were treated with either simultaneous transplantation of Matriderm, a bovine based collagen I, III, V and elastin hydrolysate based dermal substitute and split-thickness skin grafting (STSG), or STSG alone after appropriate excision of the burn wound. The study was designed as a prospective intra-individual comparative study. After 1 week all wounds were assessed for the percentage of autograft survival. Autograft survival was not altered by simultaneous application of a dermal matrix (p=0.015). Skin elasticity was measured after 3-4 months with the Vancouver Burn Skin Score (VBSS). The VBSS demonstrated a significant increase of elasticity in the group with dermal substitutes (p=0.04) as compared with non-substituted wounds for sheet autograft, but not for meshed autograft (p=0.24). From this pilot study it can be concluded that simultaneous application of a dermal matrix is safe and feasible, yielding significantly better results with respect to skin elasticity. Skin elasticity was considerably improved by the collagen/elastin dermal substitute Matriderm in combination with sheet autograft.
authors.affiliation: Department for Hand, Plastic and Reconstructive Surgery, Burn Center, BG-Trauma Center Ludwigshafen, The University of Heidelberg, Ludwig Guttmann Str. 13, D-67071 Ludwigshafen, Germany. hryssel@bgu-ludwigshafen.de
authors.forename: H
authors.initials: H
authors.lastname: Ryssel
authors.forename: E
authors.initials: E
authors.lastname: Gazyakan
authors.forename: G
authors.initials: G
authors.lastname: Germann
authors.forename: M
authors.initials: M
authors.lastname: Ohlbauer
mesh_terms: D000328:Adult; D000368:Aged; D002056:Burns / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D002921:Cicatrix / Q000503:physiopathology; D004548:Elasticity; D005260:Female; D006085:Graft Survival; D006230:Hand Injuries / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012867:Skin / Q000503:physiopathology; D016038:Skin Transplantation / Q000379:methods*; D017768:Skin, Artificial; D016896:Treatment Outcome; D014945:Wound Healing