title: Prospective study on burns treated with Integra®, a cellulose sponge and split thickness skin graft: comparative clinical and histological study--randomized controlled trial.
abstract: BACKGROUND
  The aim of this study was to compare three different methods to cover excised burn wounds in a randomized controlled trial.
  
  
  METHODS
  Fascially excised burn wounds, measuring 10 cm × 5 cm, were covered with Integra(®), split thickness skin graft (STSG), and a viscose cellulose sponge Cellonex™ in each of ten adult patients. Integra(®) and Cellonex™ treated areas were covered with thin STSG on day 14. Biopsies were taken 3, 7, 14, and 21 days, 3 months, and 12 months after surgery, and samples were subjected to a range of immunohistochemical stains, in addition to hematoxylin and eosin (HE). Scar assessment was performed 3 and 12 months post-operatively with the Vancouver Scar Scale (VSS).
  
  
  RESULTS
  Inflammation was not substantial in any of the study areas, but Cellonex™ had the most neutrophils, histiocytes, and lymphocytes with significant differences on days 7 and 14. Complete vascularization of Integra(®) seemed to occur later compared to the other materials. STSG had the most myofibroblasts on day 14 (p = 0.012). In VSS the quality of the scar improved in all materials from 3 to 12 months.
  
  
  CONCLUSIONS
  The final results for all treatments after 12 months demonstrate equal clinical appearance, as well as histological and immunohistochemical findings.
authors.affiliation: Department of Surgery, Hyvinkää Hospital, Hyvinkää, Finland. Electronic address: heli.lagus@hus.fi.
authors.forename: Heli
authors.initials: H
authors.lastname: Lagus
authors.forename: Maarit
authors.initials: M
authors.lastname: Sarlomo-Rikala
authors.forename: Tom
authors.initials: T
authors.lastname: Böhling
authors.forename: Jyrki
authors.initials: J
authors.lastname: Vuola
mesh_terms: D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use; D002056:Burns / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D002482:Cellulose / Q000627:therapeutic use*; D002809:Chondroitin Sulfates / Q000627:therapeutic use*; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic; D011446:Prospective Studies; D016038:Skin Transplantation / Q000379:methods*; D015503:Surgical Sponges; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; C114835:integra artificial skin; D002482:Cellulose; D002809:Chondroitin Sulfates; D003094:Collagen
keywords: Artificial skin substitute; Clinical and histological study; Integra; Randomized controlled trial; Viscose cellulose sponge