The use of noncellularized artificial dermis in the prevention of scar contracture and hypertrophy.

Abnormal scarring occurring after wounds and burns remains a major source of functional and cosmetic disorders. The dermal part of the skin is recognized as playing a major role in the contraction process. The skin dermis may be involved in superficial wounds, but when the basal membrane and the sources of keratinocytes, like hair follicles and adnexa, are left intact, little visible scarring is observed. The skin elasticity may be preserved, even when the extracellular matrix is somehow altered. On the opposite extreme, in wounds of extended depth, the loss of dermal component results in the absence of elasticity and fibroblastic cell proliferation, leading to hypertrophy and contracture. These phenomena may be explained either by differences in cell populations, by extracellular matrix reactions to different stimuli, or by chemical control of interactions between cells and matrix.