M Ayaz1, A Najafi1, M Y Karami1. 1. Division of Burn and Reconstructive Surgery, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
Abstract
BACKGROUND: Use of AlloDerm™ is highly suggested for the treatment of deep burns and burn sequela reconstruction. Scar formation and contracture are recognized as long-term consequences of split-thickness skin autografting, which is applied for full-thickness burn injuries. Mature fibroblasts, in the absence of dermis, seem to secrete collagen in the reformed scar pattern. OBJECTIVE: To process AlloDerm™ from fresh allograft and use it as a dermal substitute for covering deep wounds in burn patients and evaluate its effectiveness. METHODS: In this case-series, 7 patients with deep burn wounds involving different locations on the body surface were exposed to combined AlloDerm™ (processed from fresh human allograft) with thin split thickness skin autograft on it. On the 5th post-operative day, wound dressings were changed to evaluate the graft survival with the human acellular dermal matrix scaffold. To determine the skin profiles, follow-ups continued for at least 6 months. RESULTS: The results showed excellent graft take, good elasticity, acceptable thickness, and little contracture and scarring according to fix surgeon assessment in 6 patients. Graft rejection happened only in one patient with chronic electrical injury. CONCLUSION: AlloDerm™ derived from cadaver skin and combination of it with thin split thickness skin auto grafting constitute a cost-effective and favorable option for the treatment of deep burn wounds in our center, considering the increased tendency of the population towards organ donation in the event of brain death.
BACKGROUND: Use of AlloDerm™ is highly suggested for the treatment of deep burns and burn sequela reconstruction. Scar formation and contracture are recognized as long-term consequences of split-thickness skin autografting, which is applied for full-thickness burn injuries. Mature fibroblasts, in the absence of dermis, seem to secrete collagen in the reformed scar pattern. OBJECTIVE: To process AlloDerm™ from fresh allograft and use it as a dermal substitute for covering deep wounds in burn patients and evaluate its effectiveness. METHODS: In this case-series, 7 patients with deep burn wounds involving different locations on the body surface were exposed to combined AlloDerm™ (processed from fresh human allograft) with thin split thickness skin autograft on it. On the 5th post-operative day, wound dressings were changed to evaluate the graft survival with the human acellular dermal matrix scaffold. To determine the skin profiles, follow-ups continued for at least 6 months. RESULTS: The results showed excellent graft take, good elasticity, acceptable thickness, and little contracture and scarring according to fix surgeon assessment in 6 patients. Graft rejection happened only in one patient with chronic electrical injury. CONCLUSION: AlloDerm™ derived from cadaver skin and combination of it with thin split thickness skin auto grafting constitute a cost-effective and favorable option for the treatment of deep burn wounds in our center, considering the increased tendency of the population towards organ donation in the event of brain death.
Authors: D Heimbach; A Luterman; J Burke; A Cram; D Herndon; J Hunt; M Jordan; W McManus; L Solem; G Warden Journal: Ann Surg Date: 1988-09 Impact factor: 12.969
Authors: D Wainwright; M Madden; A Luterman; J Hunt; W Monafo; D Heimbach; R Kagan; K Sittig; A Dimick; D Herndon Journal: J Burn Care Rehabil Date: 1996 Mar-Apr