Comparison of a Sealed, Polymer Foam Biodegradable Temporizing Matrix Against Integra® Dermal Regeneration Template in a Porcine Wound Model
Comparison of a Sealed, Polymer Foam Biodegradable Temporizing Matrix Against Integra® Dermal Regeneration Template in a Porcine Wound Model
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DOI：
10.1097/bcr.0b013e318233fac1
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发表时间：
2012-01-01
影响因子：
1.4
通讯作者：
Dearman, Bronwyn Louise
中科院分区：
文献类型：
--
作者：
Greenwood, John Edward;Dearman, Bronwyn Louise
本研究的目的是开发和优化拟议的两阶段皮肤移植替代策略的第一阶段。这需要创造一种材料，该材料可以在烧伤切除后立即应用，以“暂时”创面，作为“新真皮”整合，抵抗收缩和感染，并为第二阶段（自体培养的复合皮肤）提供基础。在六只猪中产生四个8 × 8 cm的伤口，以评估和比较使用Integra（R）真皮再生模板、可生物降解的暂时聚合物基质（密封和未密封）和二次意图伤口的伤口收缩。所有敷料均连续。感染导致Integra（R）早期自发分层，破坏了长期比较。因此，在28天内，用密封聚合物处理的伤口收缩明显小于用Integra处理的伤口。从组织学上看，与密封聚合物相比，未密封的Integra（R）聚合物表面以及二级伤口中出现了厚厚的疤痕层，其中这种疤痕层的特征是最小的。任何聚合物处理的伤口均未观察到感染的临床体征。一旦Integra（R）硅树脂层分层，伤口收缩就变得剧烈。生物可降解密封膜的优化迫在眉睫，复合皮肤的第二阶段开发正在进行中。（J Burn Care Res 2012;33：163-173）
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 bio-degradable sealing membrane is imminent, and the second stage of composite skin development is under way. (J Burn Care Res 2012;33:163-173)