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Clinical effectiveness of dermal substitution in burns by topical negative pressure: A multicenter randomized controlled trial
Author(s) -
Bloemen Monica C. T.,
Wal Martijn B. A.,
Verhaegen Pauline D. H. M.,
Nieuwenhuis Marianne K.,
Baar Margriet E.,
Zuijlen Paul P. M.,
Middelkoop Esther
Publication year - 2012
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 - 10.1111/j.1524-475x.2012.00845.x
Subject(s) - medicine , scars , surgery , randomized controlled trial , clinical trial
Previous research has shown clinical effectiveness of dermal substitution; however, in burn wounds, only limited effect has been shown. A problem in burn wounds is the reduced take of the autograft, when the substitute and graft are applied in one procedure. Recently, application of topical negative pressure ( TNP ) was shown to improve graft take. The aim of this study was to investigate if application of a dermal substitute in combination with TNP improves scar quality after burns. In a four‐armed multicenter randomized controlled trial, a split‐skin graft with or without a dermal substitute and with or without TNP was compared in patients with deep dermal or full‐thickness burns requiring skin transplantation. Graft take and rate of wound epithelialization were evaluated. Three and 12 months postoperatively, scar parameters were measured. The results of 86 patients showed that graft take and epithelialization did not reveal significant differences. Significantly fewer wounds in the TNP group showed postoperative contamination, compared to other groups. Highest elasticity was measured in scars treated with the substitute and TNP , which was significantly better compared to scars treated with the substitute alone. Concluding, this randomized controlled trial shows the effectiveness of dermal substitution combined with TNP in burns, based on extensive wound and scar measurements.