A New Form of Artificial Skin to Promote Permanent Wound Coverage A Preliminary Report

作者：Wang Hsian Jenn^*; Wei Lin Gwei; Wang Chi Hsien; Cheng Ya Chen; Chang Junn Liang; Tsou Tai Li; Ku Chih Hung; Li Chun Chang; Chiu Wen Kuan; Chen Chieh Feng

来源：Annals of Plastic Surgery, 2017, 78: S148-S152.

DOI：10.1097/SAP.0000000000001021

• biosynthetic dressing
• Integra
• Integra dermal matrix
• silicone acellular porcine dermis
• acellular porcine dermal matrix
• incorporation
• permanent wound healing
• wound contraction

Background: Although tendon-exposed or bone-exposed wounds can be resurfaced with flaps, such surgeries may not be feasible in patients with poor general or local conditions. Biosynthetic artificial skin is an alternative for critical wound coverage. We designed a new artificial skin bilayer to close difficult wounds permanently.
Aim and Objectives: This study compares incorporation and wound contraction between silicone acellular porcine dermis (SAPD) and the Integra graft (Integra Life Sciences Corp., Billerica, Mass) in a rat model.
Materials and Methods: The SAPD was manufactured according to our previously described standard procedures. Integra grafts were obtained commercially. We included 24 male adult Sprague-Dawley rats and divided them into 2 groups. After creating a 3 x 4-cm full-thickness wound on the back, we transplanted the same-sized SAPD and Integra grafts onto the rat wounds. Autologous full-thickness skin (FTS) was grafted onto the acellular porcine dermal matrix (APDM) of the SAPD and the Integra dermal matrix (IDM) 2 weeks later. We measured the wound size and contraction rate of recipient wounds, studied the incorporation of FTS on the dermal matrix, and did pathological examination. Generalized estimating equations were used to assess the data from repeated wound and scar contraction measurements using SAS v9.2.
Results: The sizes of wounds of both groups decreased over time. No difference in wound contraction was observed between the SAPD and Integra groups at weeks 2, 4, or 6 after grafting. However, the contraction rates in both groups increased significantly. The pathological examination showed that the FTS was well incorporated in the APDM and IDM. The recipient wounds showed new vessels and cell infiltration in the new matrix, but no severe inflammation. Skin appendages were regenerating in the FTS. There was no rejection sign.
Conclusions: Both SAPD and Integra are double-layered artificial skin products. Our results demonstrate that APDM and IDM are good templates and show excellent incorporation with autologous FTS graft. The results also demonstrated gradual wound contraction over time, but the contraction rate was not different between SAPD and Integra 6 weeks after grafting in a rat model.

• 出版日期2017-3