B J Reagan1, M R Madden, J Huo, M Mathwich, L Staiano-Coico. 1. Department of General Surgery and the New York Firefighters Wound Healing Laboratory, The New York Hospital-Cornell Burn Center, New York, USA.
Abstract
BACKGROUND AND METHODS: The need for a reliable skin substitute to improve burn treatment has been long apparent. We have investigated the use of cryopreserved cellular and decellularized porcine allogeneic dermal grafts (CADGs or DADGs) in conjunction with an overlying thin split-thickness autograft (STSG) in a one-step technique. Control mirror-image wounds were treated with thin STSG alone. Autograft "take" rates and wound contraction were determined; biopsies were taken at weeks 2, 5, and 8, and blinded scar assessment was performed at week 10. RESULTS: The percent take of autografts overlying CADGs or DADGs was comparable to that of control sites (83.0 +/- 8.3% vs. 81.1 +/- 11.5% for CADG vs. control; 93.2 +/- 7.6% vs. 90.2 +/- 11.1% for DADG vs. control). CADGs did not alter wound contraction or cosmetic outcome. By contrast, DADG treatment inhibited wound contraction (42.9 +/- 17.8% vs. 30.9 +/- 10.4% contraction for control vs. DADG at week 10; p < 0.017) and significantly improved cosmetic outcome in 10 of 12 paired wounds (p < 0.012). CONCLUSION: CADGs and DADGs permitted simultaneous engraftment of an overlying thin STSG. Although CADGs had no effect on wound contraction and cosmetic outcome, DADGs significantly reduced wound contraction and improved cosmetic outcome of full-thickness wounds in a porcine model. The use of DADGs may represent a potential improvement in burn care.
BACKGROUND AND METHODS: The need for a reliable skin substitute to improve burn treatment has been long apparent. We have investigated the use of cryopreserved cellular and decellularized porcine allogeneic dermal grafts (CADGs or DADGs) in conjunction with an overlying thin split-thickness autograft (STSG) in a one-step technique. Control mirror-image wounds were treated with thin STSG alone. Autograft "take" rates and wound contraction were determined; biopsies were taken at weeks 2, 5, and 8, and blinded scar assessment was performed at week 10. RESULTS: The percent take of autografts overlying CADGs or DADGs was comparable to that of control sites (83.0 +/- 8.3% vs. 81.1 +/- 11.5% for CADG vs. control; 93.2 +/- 7.6% vs. 90.2 +/- 11.1% for DADG vs. control). CADGs did not alter wound contraction or cosmetic outcome. By contrast, DADG treatment inhibited wound contraction (42.9 +/- 17.8% vs. 30.9 +/- 10.4% contraction for control vs. DADG at week 10; p < 0.017) and significantly improved cosmetic outcome in 10 of 12 paired wounds (p < 0.012). CONCLUSION: CADGs and DADGs permitted simultaneous engraftment of an overlying thin STSG. Although CADGs had no effect on wound contraction and cosmetic outcome, DADGs significantly reduced wound contraction and improved cosmetic outcome of full-thickness wounds in a porcine model. The use of DADGs may represent a potential improvement in burn care.
Authors: Jorge H Gomez; Jim Schumacher; Susan D Lauten; Eva A Sartin; Terri L Hathcock; Steven F Swaim Journal: Can J Vet Res Date: 2004-01 Impact factor: 1.310