Department of Plastic Surgery, Hôpital Nord, Chemin des Bourrely, 13915 Marseille, France.
Burns. 2012 Sep;38(6):820-9. doi: 10.1016/j.burns.2012.02.008. Epub 2012 May 30.
The wound healing attributes of five acellular dermal skin substitutes were compared, in a two-step procedure, in a porcine model. Ten pigs were included in this experimental and randomized study. During the first step, dermal substitutes (Integra(®), ProDerm(®), Renoskin(®), Matriderm(®) 2mm and Hyalomatrix(®) PA) were implanted into full-thickness skin wounds and the epidermis was reconstructed during a second step procedure at day 21 using autologous split-thickness skin graft or cultured epithelial autograft. Seven pigs were followed-up for 2 months and 3 pigs for 6 months. Dermal substitute incorporation, epidermal graft takes, wound contraction and Vancouver scale were assessed, and histological study of the wounds was performed. Results showed significant differences between groups in dermis incorporation and in early wound contraction, but there was no difference in wound contraction and in Vancouver scale after 2 and 6 months of healing. We conclude there was no long-term difference of scar qualities in our study between the different artificial dermis. More, there was no difference between artificial dermis and the control group. This study makes us ask questions about the benefit of artificial dermis used in a two-step procedure.
在一项两步法的猪模型实验中，比较了 5 种脱细胞真皮替代物的伤口愈合属性。10 头猪参与了这项实验和随机研究。在第一步中，真皮替代物（Integra®、ProDerm®、Renoskin®、Matriderm® 2mm 和 Hyalomatrix® PA）被植入全层皮肤伤口中，并在第 21 天使用自体刃厚皮片或培养的上皮自体移植物进行第二步手术重建表皮。7 头猪随访 2 个月，3 头猪随访 6 个月。评估了真皮替代物的植入、表皮移植物的成活率、伤口收缩和温哥华瘢痕量表，并对伤口进行了组织学研究。结果显示，各组在真皮植入和早期伤口收缩方面存在显著差异，但在愈合 2 个月和 6 个月后，伤口收缩和温哥华瘢痕量表无差异。我们的研究结论是，在不同的人工真皮之间，在疤痕质量方面没有长期的差异。此外，人工真皮与对照组之间也没有差异。这项研究使我们对两步法中使用人工真皮的益处产生了疑问。
