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The Use of Dermal Substitutes in Burn Surgery: Acute Phase

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Dermal Replacements in General, Burn, and Plastic Surgery

Abstract

Dermal substitutes are becoming more and more an essential part of burn care. During the acute phase of burn treatment, dermal substitutes improve functional and cosmetic results long term and thus enhance quality of life. In the chronic wound setting, dermal substitutes are used to reconstruct and improve burn scars and other defects. Despite the potential and need of dermal substitutes, further research is required not only to strengthen scientific evidence regarding their effects but also to develop new technology and products. Furthermore, dermal substitutes also emerge as pivotal research strategies to develop adequate scaffolds for stem cells, tissue engineering and regenerative medicine applications to obtain long-lasting and scarless artificial skin.

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References

  • Akguner M, Barutcu A, Yilmaz M, Baratas O, Vayvada H (1998) Marjolin’s ulcer and chronic burn scarring. J Wound Care 7:121–122

    PubMed  CAS  Google Scholar 

  • Alisky JM (2004) Xenografts are an achievable breakthrough. Med Hypotheses 63:92–97

    Article  PubMed  CAS  Google Scholar 

  • Andreadis ST, Hamoen KE, Yarmush ML, Morgan JR (2001) Keratinocyte growth factor induces hyperproliferation and delays differentiation in a skin equivalent model system. FASEB J 15(6):898–906

    Article  PubMed  CAS  Google Scholar 

  • Arno A, Smith AH, Blit PH, Al Shehab M, Gauglitz GG, Jeschke MG (2011) Stem cell therapy: a new treatment for burns? Pharmaceuticals 4(10):1355–1380. doi:10.3390/ph4101355

    Article  CAS  Google Scholar 

  • Atiyeh B, Costagliola M (2007) Cultured epithelial autograft (CEA) in burn treatment: three decades later. Burns 33:405–413

    Article  PubMed  Google Scholar 

  • Bello YM, Falabella AF, Eaglstein WH (2001) Tissue-engineered skin. Current status in wound healing. Am J Clin Dermatol 2(5):305–313

    Article  PubMed  CAS  Google Scholar 

  • Bloemen MCT, van Leeuwen MCE, van Vucht NE, van Zuijlen PP, Middelkoop E (2010) Dermal substitution in acute burns and reconstructive surgery: a 12-year follow-up. Plast Reconstr Surg 125:1450–1459

    Article  PubMed  CAS  Google Scholar 

  • Bombaro KM, Engrav LH, Carrougher GJ, Wiechman SA, Faucher L, Costa BA, Heimbach DM, Rivara FP, Honari S (2003) What is the prevalence of hypertrophic scarring following burns? Burns 29:299–302

    Article  PubMed  Google Scholar 

  • Bouchle A (2002) Tissue engineering firms go under. Nat Biotechnol 20:1178–1179

    Article  Google Scholar 

  • Boyce ST (1996) Cultured skin substitutes: a review. Tissue Eng 2(4):255–269

    Article  PubMed  CAS  Google Scholar 

  • Boyce ST (2001) Design principles for composition and performance of cultured skin substitutes. Burns 27(5):523–533

    Article  PubMed  CAS  Google Scholar 

  • Branski LK, Herndon DN, Pereira C, Mlcak RP, Celis MM, Lee JO, Sanford AP, Norbury WB, Zhang XJ, Jeschke MG (2007) Longitudinal assessment of Integra in primary burn management: a randomized pediatric clinical trial. Crit Care Med 35(11):2615–2623

    Article  PubMed  Google Scholar 

  • Burke JF, Yannas IV, Quinby WC Jr, Bondoc CC, Jung WK (1981) Successful use of a physiologically acceptable artificial skin in the treatment of extensive burn injury. Ann Surg 194:413–428

    Article  PubMed  CAS  Google Scholar 

  • Chalmers RL, Smock E, Geh JLC (2010) Experience of Integra in cancer reconstructive surgery. J Plast Reconstr Aesthet Surg 63:2081–2090

    Article  PubMed  CAS  Google Scholar 

  • Clark RAF, Ghosh K, Tonnesen MG (2007) Tissue engineering for cutaneous wounds. J Invest Dermatol 127:1018–1029

    Article  PubMed  CAS  Google Scholar 

  • Cooper M, Hansbrough J, Spielvogel R, Cohen R, Bartel RL, Naughton G (1991) In vivo optimization of a living dermal substitute employing cultured human fibroblasts on a biodegradable polyglycolic acid or polyglactin mesh. Biomaterials 12:243–248

    Article  PubMed  CAS  Google Scholar 

  • Dantzer E, Queruel P, Salinier L, Palmier B, Quinot JF (2003) Dermal regeneration template for deep hand burns: clinical utility for both early grafting and reconstructive surgery. Br J Plast Surg 56:764–774

    Article  PubMed  CAS  Google Scholar 

  • der Veen van VC, Boekema BKHL, Ulrich MMW, Middelkoop E (2011) New dermal substitutes. Wound Repair Regen 19:S59–S65

    Article  Google Scholar 

  • Fette A (2005) Integra artificial skin in use for full-thickness burn surgery: benefits or harms on patient outcome. Technol Health Care 13:463–468

    PubMed  Google Scholar 

  • Ge L, Zheng S, Wei H (2009) Comparison of histological structure and biocompatibility between human acellular dermal matrix (ADM) and porcine ADM. Burns 35(1):46–50

    Article  PubMed  Google Scholar 

  • Ghosh MM, Boyce S, Layton C, Freedlander E, Mac Neil S (1997) A comparison of methodologies for the preparation of human epidermal-dermal composites. Ann Plast Surg 39:390–404

    Article  PubMed  CAS  Google Scholar 

  • Gottlieb ME, Furman J (2004) Successful management and surgical closure of chronic and pathological wounds using Integra. J Burns Surg Wound Care 3:4–60

    Google Scholar 

  • Gravante G, Delogu D, Giordan N, Morano G, Montone A, Esposito G (2007) The use of hyalomatrix PA in the treatment of deep partial-thickness burns. J Burn Care Res 28:269–274

    Article  PubMed  Google Scholar 

  • Halim AS, Khoo TL, Mohd Yussof SJ (2010) Biologic and synthetic skin substitutes: an overview. Indian J Plast Surg 43:S23–S28

    Article  PubMed  Google Scholar 

  • Hansbrough J (1995) Status of cultured skin replacement. Wounds 7(4):130–136

    Google Scholar 

  • Hansbrough JF, Mozingo DW, Kealey GP, Davis M, Gidner A, Gentzkow GD (1997) Clinical trials of a biosynthetic temporary skin replacement, Dermagraft- Transitional Covering, compared with cryopreserved human cadaver skin for temporary coverage of excised burn wounds. J Burn Care Rehabil 18:43–51

    Article  PubMed  CAS  Google Scholar 

  • Hansen SL, Voigt DW, Wiebelhaus P, Paul CN (2001) Using skin replacement products to treat burns and wounds. Adv Skin Wound Care 14:37–44

    Article  PubMed  CAS  Google Scholar 

  • Haslik W, Kamolz LP, Manna F et al (2010) Management of full-thickness skin defects in the hand and wrist region: first long-term experiences with the dermal matrix matriderm. J Plast Reconstr Aesthet Surg 63:360–364

    Article  PubMed  CAS  Google Scholar 

  • Hodgkinson T, Bayat A (2011) Dermal substitute-assisted healing: enhancing stem cell therapy with novel biomaterial design. Arch Dermatol Res 303:301–315

    Article  PubMed  CAS  Google Scholar 

  • Jaksic T, Burke JF (1987) The use of artificial skin for burns. Annu Rev Med 38:107–117

    Article  PubMed  CAS  Google Scholar 

  • Jones I, Currie L, Martin R (2002) A guide to biological skin substitutes. Br J Plast Surg 55:185–193

    Article  PubMed  CAS  Google Scholar 

  • Kolokythas P, Aust MC, Vogt PM, Paulsen F (2008) Dermal substitute with the collagen-elastin matrix Matriderm in burn injuries: a comprehensive review. Handchir Mikrochir Plast Chir 40:367–371

    Article  PubMed  CAS  Google Scholar 

  • Krejci NC, McGuire J (1992) Treatment of burns with skin substitutes. J Dermatol Sci 4:149–155

    Article  PubMed  CAS  Google Scholar 

  • Krueger GG, Morgan JR, Jorgensen CM, Schmidt L, Li HL, Kwan MK, Boyce ST, Wiley HS, Kaplan J, Petersen MJ (1994) Genetically modified skin to treat disease: potential and limitations. J Invest Dermatol 103(5 Suppl):76S–84S

    Article  PubMed  CAS  Google Scholar 

  • Leclerc T, Thepenier PJ, Bey E, Peltzer J, Trouillas M, Duhamel P, Bargues L, Prat M, Bonderriter M, Lataillade JJ (2011) Cell therapy of burns. Cell Prolif 44:48–54

    Article  PubMed  Google Scholar 

  • Lee KH (2000) Tissue-engineered human living skin substitutes: development and clinical application. Yonsei Med J 41(6):77–779

    Google Scholar 

  • Leventhal D, Furr M, Reiter D (2006) Treatment of keloids and hypertrophic scars. Arch Facial Plast Surg 8:362–368

    Article  PubMed  Google Scholar 

  • Machens HG, Berger AC, Mailaender P (2000) Bioartificial skin. Cells Tissues Organs 167:88–94

    Article  PubMed  CAS  Google Scholar 

  • Muangman P, Engrav LH, Heimbach DM, Harunari N, Honari S, Gibran NS, Klein MB (2006) Complex wound management utilizing an artificial dermal matrix. Ann Plast Surg 57(2):199–202

    Article  PubMed  CAS  Google Scholar 

  • Murray RC, Gordin EA, Saigal K, Leveenthal D, Krein H, Heffelfinger RN (2011) Reconstruction of the radial forearm free flap donor site using Integra artificial dermis. Microsurgery 31:104–108

    Article  PubMed  Google Scholar 

  • Myers SR, Partha VN, Soranzo C, Price RD, Navsaria HA (2007) Hyalomatrix: a temporary epidermal barrier, hyaluronan delivery, and neodermis induction system for keratinocyte stem cell therapy. Tissue Eng 13:2733–2741

    Article  PubMed  CAS  Google Scholar 

  • Nanchatal J, Dover R, Otto WR (2002) Allogeneic skin substitutes applied to burns patients. Burns 28:254–257

    Article  Google Scholar 

  • Nguyen DQ, Dickson WA (2006) A review of the use of a dermal skin substitute in burns care. J Wound Care;15(8):373–376

    Article  PubMed  Google Scholar 

  • Nguyen DQ, Potokar TS, Price P (2010) An objective long-term evaluation of Integra (a dermal skin substitute) and split thickness skin grafts, in acute burns and reconstructive surgery. Burns 36:23–28

    Article  PubMed  Google Scholar 

  • Pham C, Greenwood J, Cleland H, Woodruff P, Maddern G (2007) Bioengineered skin substitutes for the management of burns: a systematic review. Burns 33:946–957

    Article  PubMed  Google Scholar 

  • Phillips TJ (1993) Biologic skin substitutes. J Dermatol Surg Oncol 19(8):794–800

    PubMed  CAS  Google Scholar 

  • Pirayesh A, Monstrey S, Blondeel P, Hoekstra H, Vanoorbeek J, Hoeksema H, Richters CD (2007) Development of a novel dermal substitute based on glycerinized allograft: clinical (Phase I) and experimental evaluation. Burns 33:S13

    Article  Google Scholar 

  • Prunieras M, Regnier M, Woodley D (1983) Methods for cultivation of keratinocytes with an air-liquid interface. J Invest Dermatol 81(1 Suppl):28s–33s

    Article  PubMed  CAS  Google Scholar 

  • Purdue GF (1997) Dermagraft-TC pivotal safety and efficacy study. J Burn Care Rehabil 18:S13–S14

    Article  PubMed  CAS  Google Scholar 

  • Purdue GF, Hunt JL, Still JM Jr, Law EJ, Herndon DN, Goldfarb IW, Schiller WR, Hansbrough JF, Hickerson WL, Himel HN, Kealey GP, Twomey J, Missavage AE, Solem LD, Davis M, Totoritis M, Gentzkow GD (1997) A multicenter clinical trial of a biosynthetic skin replacement, Dermagraft-TC, compared with cryopreserved human cadaver skin for temporary coverage of excised burn wounds. J Burn Care Rehabil 18:52–57

    Article  PubMed  CAS  Google Scholar 

  • Ralston DR, Layton C, Dalley AJ, Boyce SG, Freedlander E, Mac Neil S (1999) The requirement for basement membrane antigens in the production of human epidermal/dermal composites in vitro. Br J Dermatol 140:605–615

    Article  PubMed  CAS  Google Scholar 

  • Rennekampff HO (2009) Hautersatzverfahren in der Verbrennungschirurgie. Unfallchirurg 112:543–549

    Article  PubMed  Google Scholar 

  • Richters CD, Pirayesh A, Hoeksema H, Kamperdijk WA, Kries RW, Dutrieux RP, Monstrey S, Hoekstra MJ (2008) Development of a dermal matrix from glycerol preserved allogeneic skin. Cell Tissue Bank 9:309–315

    Article  PubMed  CAS  Google Scholar 

  • Rnjak J, Wise SG, Mithieux SM et al (2011) Severe burn injuries and the role of elastin in the design of dermal substitutes. Tissue Eng 17(2):81–93

    Article  CAS  Google Scholar 

  • Ruszczak Z (2003) Effect of collagen matrices on dermal wound healing. Adv Drug Deliv Rev 55:1595–1611

    Article  PubMed  CAS  Google Scholar 

  • Ryssel H, Gazyakan E, Germann G, Ohlbauer M (2008) The use of Matriderm in early excision and simultaneous autologous skin grafting in burns: a pilot study. Burns 34:93–97

    Article  PubMed  CAS  Google Scholar 

  • Saffle JR (1998) Predicting outcomes of burns. N Engl J Med 338(6):387–388

    Article  PubMed  CAS  Google Scholar 

  • Schneider J, Biedermann T, Widmer D, Montano I, Meuli M, Reichmann E, Schiestl C (2009) MatriDerm® versus Integra®: a comparative experimental study. Burns 35:51–57

    Article  PubMed  Google Scholar 

  • Shakespeare P (2001) Burn wound healing and skin substitutes. Burns 27:517–522

    Article  PubMed  CAS  Google Scholar 

  • Sheridan RL, Hegarty M, Tompkins RG, Burke JF (1994) Artificial skin in massive burns: results to ten years. Eur J Plast Surg 17:91–93

    Article  Google Scholar 

  • Shores JT, Gabriel A, Gupta S (2007) Skin substitutes and alternatives: a review. Adv Skin Wound Care 20:493–508

    Article  PubMed  Google Scholar 

  • Truong AN, Kowal-Vern A, Latenser BA, Wiley DE, Walter RJ (2005) Comparison of dermal substitutes in wound healing utilizing a nude mouse model. J Burns Wounds 4:e4

    PubMed  Google Scholar 

  • Van Der Veen VC, van der Wal MBA, van Leuwen MCE, Ulrich MMW, Middelkoop E (2010) Biological background of dermal substitutes. Burns 36:305–321

    Article  PubMed  Google Scholar 

  • Wainwright DJ (1995) Use of an acellular allograft dermal matrix (AlloDerm) in the management of full-thickness burns. Burns 21(4):243–248

    Article  PubMed  CAS  Google Scholar 

  • Wainwright D, Madden M, Luterman A, Hunt J, Monafo W, Heimbach D, Kagan R, Sittig K, Dimick A, Herndon D (1996) Clinical evaluation of an acellular allograft dermal matrix in full-thickness burns. J Burn Care Rehabil 17(2):124–136

    Article  PubMed  CAS  Google Scholar 

  • Wang H, Pieper J, Peters F, van Vlitterswijk CA, Lamme EN (2005) Synthetic scaffold morphology controls human dermal connective tissue formation. J Biomed Mater Res 74:523–532

    Article  Google Scholar 

  • Yannas IV, Burke JF (1980) Design of an artificial skin. I. Basic design principles. J Biomed Mater Res 1:65–81

    Article  Google Scholar 

  • Yannas IV, Burke JF, Gordon PL, Huang C, Rubenstein RH (1980) Design of an artificial skin. II. Control of chemical composition. J Biomed Mater Res 14:107–132

    Article  PubMed  CAS  Google Scholar 

  • Zhang CP, Fu XB (2008) Therapeutic potential of stem cells in skin repair and regeneration. Chin J Traumatol 11:209–221

    PubMed  CAS  Google Scholar 

  • Zuijlen van PP, Angeles AP, Kreis RW, Bos KE, Middelkoop E (2002) Scar assessment tools: implications for current research. Plast Reconstr Surg 109(3):1108–1122

    Article  Google Scholar 

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Correspondence to Marc G. Jeschke MD, PhD .

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Arno, A.I., Jeschke, M.G. (2013). The Use of Dermal Substitutes in Burn Surgery: Acute Phase. In: Kamolz, LP., Lumenta, D. (eds) Dermal Replacements in General, Burn, and Plastic Surgery. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1586-2_16

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