title: ﻿﻿﻿﻿﻿﻿﻿Bilayer dermal matrix for the treatment of painful burn scars.
abstract: ﻿﻿﻿﻿﻿﻿ Background. Outcomes following burn injury have improved considerably in recent years due to early excision and skin grafting. Despite a reduction in late burn complications, up to 70% of patients experience long-term pain at both the injured area and the skin-grafted scar. Current therapies do not ameliorate these symptoms for a majority of these patients. This report presents initial results of a new technique using a bilayer dermal substitute (Integra™, [Integra LifeSciences, Plainsboro, NJ]) for revision of painful scars.
  
  
  METHODS
  This is a prospective cohort of six patients treated at Grady Memorial Hospital Burn Center (Atlanta, GA) from 2008 to 2009. Burn patients undergoing multi-modality pain therapy for chronic, painful burns were identified and consented for intervention. All patients underwent operative excision of the painful scar and placement of a bilayer dermal matrix (Integra). After 3 weeks the silicone mesh was removed, excessive granulation tissue was debrided, and a new split-thickness skin graft was placed on the wound. Prescription history and a patient questionnaire were used to collect data.
  
  
  RESULTS
  All patients noticed improvement of symptoms post-operatively. Two patients (33%) experienced complete reduction of scar pain and three (50%) discontinued consumption of pain medications. At a mean follow up of 13 months, the average amount of narcotic-based pain medications decreased from 63.3 MED ([morphine equivalent per day], range: 30-135) before treatment to 7.5 MED (range: 0-20) postoperatively (P < 0.05).
  
  
  CONCLUSIONS
  Scar excision, interval placement of a bilayer dermal matrix, and subsequent skin grafting is a new technique that can improve, and in some cases ameliorate, burn scar related pain. ﻿﻿﻿.
authors: ﻿Emory University School of Medicine, Atlanta, GA; Email: hmoyer@emory.edu.
authors: Hunter R
authors: HR
authors: Moyer
authors: Emory University School of Medicine, Atlanta, GA.
authors: Maksym
authors: M
authors: Yezhelyev
authors: Emory University School of Medicine, Atlanta, GA.
authors: Walter L
authors: WL
authors: Ingram