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Dermal substitutes for full‐thickness wounds in a one‐stage grafting model
Author(s) -
De Vries Henry J. C.,
Mekkes Jan R.,
Middelkoop Esther,
Hinrichs Wouter L. J.,
Wildevuur Charles R. H.,
Westerhof Wiete
Publication year - 1993
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1046/j.1524-475x.1993.10410.x
Subject(s) - dermis , wound healing , acellular dermis , skin grafting , fibroblast , microporous material , artificial skin , surgery , biomedical engineering , contraction (grammar) , skin equivalent , medicine , materials science , chemistry , anatomy , composite material , keratinocyte , biochemistry , implant , in vitro
We tested different biodegradable matrix materials as dermal substitutes in a porcine wound model. Matrixes were covered with a split‐skin mesh graft and protected with a microporous, semipermeable membrane, which prevents blister formation, wound infection and provides ultimate healing conditions. Evaluation parameters were as follows: epithelization, dermal reconstitution, wound contraction, and cosmetic and functional aspect. A microfibrillar matrix of nondenatured collagen gave the best result, with immediate fibroblast ingrowth and epidermal outgrowth. Slight inflammatory reaction and minimal wound contraction were observed. Application of a split‐skin mesh graft, in combination with this collagen matrix, generated a thicker dermal layer than did a split‐skin mesh graft directly applied on a wound bed. However, the histologic dermal architecture was less optimal than one obtained with a full‐thickness punch graft method. Other matrixes caused inflammatory reactions, interfering with epithelization and dermal reconstitution. We conclude that a nondenatured collagen matrix, in combination with a split‐skin mesh graft, can provide a substitute dermis in a full‐thickness wound. This combination is preferable to a split‐skin mesh graft directly applied on the wound bed. With our microporous semipermeable membrane, the combined use of a dermal substitute and a split‐skin mesh graft can be applied in a single‐stage operation.