Development and Clinical Evaluation Synthetic Skin Substitute as a Model of Skin Function,
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
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Temporary skin substitutes, including human cadaver cutaneous allografts, porcine cutaneous xenografts, and amniotic membranes have become widely used in the treatment of thermally injured patients. The principal use of these biologic dressings is for temporary coverage of full thickness burn wounds, after the necrotic eschar has separated from the underlying tissue. In addition, the use of such dressings has been advocated for the early treatment of partial thickness burns, for temporary coverage of surgically excised burn wounds, and for other traumatic wounds involving full-thickness skin loss. We believe that the beneficial effects of cutaneous allograft, and perhaps the other biologic dressings, are related to two interrelated properties, First, membrane function is provided by the epidermal surface of the graft, which limits fluid, electrolyte, and colloid losses from the wound and acts as a barrier against external infection. The second property relates to wound closure. With graft take, the dermal surface adheres closely to the underlying tissue and is rapidly invaded by fibroblastic and vascular ingrowth from the wound. This interaction is thought to create a favorable environment in which cellular and other defense mechanisms may decontaminate the wound.