Comparison of a sealed, polymer foam biodegradable temporizing matrix against Integra(R) dermal regeneration template in a porcine wound model.

摘要

The aim of this study is to develop and optimize the first stage of a proposed two-stage skin graft replacement strategy. This entails creation of a material that can be applied immediately after burn excision to "temporize" the wound bed, become integrated as a "neodermis," resist contraction and infection, and provide the grounding for the second stage (an autologous, cultured composite skin). Four 8 x 8 cm wounds were generated in six pigs to assess and compare wound contraction using Integra(R) dermal regeneration template, a biodegradable temporizing polymer matrix (sealed and unsealed), and a secondary intention wound. All dressings were contiguous. Infection resulted in early spontaneous delamination of the Integra(R) marring the long-term comparison. The wounds treated with the sealed polymer thus contracted significantly less than the wounds treated with Integra(R) over the 28 days. Histologically, a thick layer of scar developed superficial to the Integra(R), unsealed polymer, and in the secondary intention wounds when compared with the sealed polymer, where such a scar layer was characteristically minimal. No clinical signs of infection were observed for any polymer-treated wound. Once the Integra(R) silicone layer delaminated, wound contraction was aggressive. Optimization of the biodegradable sealing membrane is imminent, and the second stage of composite skin development is under way.