title: Comparison of a sealed, polymer foam biodegradable temporizing matrix against Integra® dermal regeneration template in a porcine wound model.
abstract: The aim of this study is to develop and optimize the first stage of a proposed two-stage skin graft replacement strategy. This entails creation of a material that can be applied immediately after burn excision to "temporize" the wound bed, become integrated as a "neodermis," resist contraction and infection, and provide the grounding for the second stage (an autologous, cultured composite skin). Four 8 × 8 cm wounds were generated in six pigs to assess and compare wound contraction using Integra® dermal regeneration template, a biodegradable temporizing polymer matrix (sealed and unsealed), and a secondary intention wound. All dressings were contiguous. Infection resulted in early spontaneous delamination of the Integra® marring the long-term comparison. The wounds treated with the sealed polymer thus contracted significantly less than the wounds treated with Integra® over the 28 days. Histologically, a thick layer of scar developed superficial to the Integra®, unsealed polymer, and in the secondary intention wounds when compared with the sealed polymer, where such a scar layer was characteristically minimal. No clinical signs of infection were observed for any polymer-treated wound. Once the Integra® silicone layer delaminated, wound contraction was aggressive. Optimization of the biodegradable sealing membrane is imminent, and the second stage of composite skin development is under way.
authors: Adult Burn Centre, Royal Adelaide Hospital, Adelaide, South Australia, Australia. john.grenwood@health.sa.gov.au
authors: John Edward
authors: JE
authors: Greenwood
authors: Bronwyn Louise
authors: BL
authors: Dearman
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D002809:Chondroitin Sulfates; D003094:Collagen; D020405:Dermis / Q000473:pathology / Q000601:surgery; D004195:Disease Models, Animal; D006084:Graft Rejection; D006085:Graft Survival; D007150:Immunohistochemistry; D011108:Polymers / Q000627:therapeutic use*; D011897:Random Allocation; D012307:Risk Factors; D016038:Skin Transplantation / Q000009:adverse effects / Q000379:methods*; D017768:Skin, Artificial; D013552:Swine; D014945:Wound Healing / Q000502:physiology*; D014947:Wounds and Injuries / Q000473:pathology / Q000601:surgery*
chemical_list: D011108:Polymers; C114835:integra artificial skin; D002809:Chondroitin Sulfates; D003094:Collagen