Clinical Outcome of Cryopreserved Acellular Dermal Matrix for Full-Thickness Burns

摘要

This study aimed at identifying properties of cryopreserved acellular dermal matrix (CPADM) and evaluating its effectiveness in the treatment of burn patients. The prospective study included 50 patients who received split-thickness skin grafts with CPADM over joints between January 2010 and July 2012. From June to October 2014, a total of 11 patients revisited our burn clinic for evaluation of the range of motion (ROM) of the joints in the involved areas. Additionally, an assessment of the condition of the grafted skin was made with regard to skin elasticity, transepidermal water loss (TEWL), and melanin and erythema levels. 19 of 50 patients who received CPADM and 31 of the 64 patients who received a freeze-dried acellular dermal matrix (FDADM) agreed to undergo analysis of the conditions of their scars. The CPADM was introduced in 2009. It was created using a controlled-rate freezer with a cryopreservation solution and was evaluated with regard to its tensile strengths and angiogenic factor release. In all, 53.8% of patients who had received the CPADM application had no ROM limitations afterwards. The TEWL in the CPADM-grafted areas was similar to that in normal skin; however, there was significantly less elasticity and higher melanin and erythema values in the grafted areas than in normal skin. Application of CPADM was more effective than that of FDADM in terms of scar thickness, elasticity, and TEWL levels (0.13±0.04 vs . 0.2±0.1 cm, 0.67±0.27 vs . 0.456±0.48 mm, and 16.2±6.8 vs . 12.1±5.3 g/h/m_(2), respectively). Therefore, the CPADM for split-thickness skin grafts is a safe and effective dermal replacement for one-stage surgery in patients with acute burns.