| Abstrakt: |
Survival of the autograft and objective parameters for scar elasticity were evaluated after dermal substitution for acute burns and reconstructive surgery. The dermal substitute, which was based on bovine type I collagen and elastinhydrolysate, was evaluated by intraindividual comparison in a clinical trial. The substitute was applied in a onestep procedure in combination with a splitthickness autograft. This treatment was compared with the conventional treatment, the splitthickness autograft. After 1 week, the percentage of autograft survival was assessed. The Cutometer SEM 474 was used to obtain objective measurements of skin elasticity parameters 3 to 4 months postoperatively. Fortytwo pairs of wounds 31 patients, age 32.9 ± 19.3 years burned surface area, 19.8 ± 14.5 percent were treated because of acute burns. Reconstructive surgery was performed on 44 pairs of wounds 31 patients, age 33.9 ± 17.5 years. Autograft survival was not altered by the substitute for reconstructive wounds, although a slight but significant reduction p0.015 was established in the burn category for substituted compared with nonsubstituted wounds. However, the necessity for regrafting was not increased by substitution. Cutometer measurements of reconstructive wounds with a dermal substitute demonstrated a significant increase of pliability 50 percent, p< 0.001, elasticity defined as immediate extension, 33 percent, p0.04, maximal extension 33 percent, p0.002, and immediate retraction 31 percent, p0.01, as compared with nonsubstituted wounds. After burn surgery, no improvement was found for the different elasticity parameters. Dermal substitution in a onestage grafting model seems feasible with respect to graft survival. Skin elasticity was considerably improved by the collagenelastin dermal substitute after reconstructive surgery. Plast. Reconstr. Surg.106 615, 2000. |
