title: Contracture of skin graft in human burns: effect of artificial dermis.
abstract: BACKGROUND
  Skin grafts with an artificial dermis have been widely used as a part of the efforts to minimize contractures and reduce donor-site scars. We conducted a prospective randomized clinical trial to study the effect of a dermal substitute by measuring the size of the graft after surgery for months.
  
  
  METHODS
  The artificial dermis (Matriderm, Dr. Suwelack Skin and Health Care AG, Billerbeck, Germany) was applied in combination with a split-thickness autograft in 40 patients with acute burn wounds or scar reconstruction. Demographic and medical data were collected on each patient. We directly measured the graft size by using a transparent two-ply film (Visitrak Grid, Smith & Nephew Wound Management, Inc, Largo, FL, USA) intraoperatively and 1, 2, 3, and 6 months postoperatively. For effective data comparison, the size of the graft at the time of surgery was taken to be "100%." Then, the size in each phase was estimated in percentage (%).
  
  
  RESULTS
  During the 1st month, the average size was 89%. The figure decreased to 86% and 82% in the 2nd and 3rd months, respectively. In the 6th month, it slightly rebounded to 85% but failed to return to the original state. The size of patients with acute burns was smaller than the size of scar patients as follows: 85-91% in the 2nd month, 81-87% in the 3rd month, and 85-96% in the 6th month.
  
  
  CONCLUSIONS
  This study examined the progress of skin grafts through the measurement of graft size in the human body. The grafted skin underwent contracture and remodeling for 3-6 months. In terms of skin contraction, an acute burn was more serious than scar reconstruction. The use of an artificial dermis that contains elastin is very effective from the functional and esthetic perspective by minimizing contractures and enhancing skin elasticity.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea.
authors.forename: Gi-Yeun
authors.initials: GY
authors.lastname: Hur
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea.
authors.forename: Dong-Kook
authors.initials: DK
authors.lastname: Seo
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea. Electronic address: jwlps@hallym.or.kr.
authors.forename: Jong-Wook
authors.initials: JW
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000150:complications / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000209:etiology / Q000601:surgery*; D003094:Collagen / Q000627:therapeutic use*; D003286:Contracture / Q000473:pathology*; D004549:Elastin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011183:Postoperative Complications / Q000473:pathology*; D012867:Skin / Q000473:pathology*; D016038:Skin Transplantation / Q000379:methods*; D017768:Skin, Artificial; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C532298:matriderm; D003094:Collagen; D004549:Elastin
keywords: Artificial dermis; Burn; Contracture; Size; Skin graft