Integra as a Dermal Replacement in a Meshed Composite Skin Graft in a Rat Model: A One-Step Operative Procedure

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Abstract:

Background Current use of Integra, the collagen-based dermal analogue, requires a two-step grafting procedure to achieve wound closure with an ultrathin autograft. Methods A one-step operative procedure of meshed composite skin graft MCSG using Integra as a dermal template for a meshed split thickness autograft was developed in rats. The silicon layer of Integra was removed, the resulting dermal analogue was meshed 11.5, expanded, and placed on excised full thickness wound and covered with a meshed 11.5 or 16 split thickness autograft. Grafted wounds were dressed with BioBrane, Vaseline gauze, silver-impregnated nylon, or silver-nylon and direct current SNDC. At scheduled intervals up to 3 months postgrafting, wounds were examined for epithelialization, collagen deposition and fibrosis, hair growth, and contraction. The results of wound clo- sure and healing following the one-step procedure were compared with the out- come of the two-step grafting procedure where application of meshed Integra step one was followed in 14 days by removal of the silicon layer and application of the meshed autograft step two. Results The one-step procedure applied to meshed autograftIntegra 11.5 11.5 composite graft accelerated wound closure by 6-19 days when compared with the two-step procedure. At 3 months post- grafting, the contraction of the healed wound dressed with SNDC, BioBrane, or Vaseline gauze was reduced by 13-16 following the one-step procedure compared with the two-step procedure p less than 0.05. The one-step procedure allowed the expansion of the autograft layer to 16 while achieving wound healing results similar to grafting with 11.5 meshed autograft layer using the two-step grafting procedure.

Author(s):
Chu, Chi-sing ; Mcmanus, Albert T. ; Matylevich, Natalia P. ; Goodwin, Cleon W. ; Pruitt, Jr, Basil A.
Author Organization(s):
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
Descriptive Note:
Journal article
Supplementary Note:
Published in the Journal of Trauma, Injury, Infection, and Critical Care, v52 p122-129, January 2002. Presented at the 10th Congress of the International Society for Burn Injuries, held in Jerusalem, Israel, 1-5 November 1998.
Pagination:
0009

Security Markings

DOCUMENT & CONTEXTUAL SUMMARY

Distribution:
Approved For Public Release
Distribution Statement:
Approved For Public Release; Distribution Is Unlimited.

RECORD

Collection: TR
Identifying Numbers
Monitor Series:
USAISR
 Subject Terms
Joint Capability Areas:
JCA_3.2_Engagement; JCA_3_Force Application; JCA_5_Command and Control; JCA_6_Net Centric; JCA_5.3_Planning; JCA_6.4.1_Secure Information Exchange; JCA_1.4.1_Force Health Protection; JCA_1.4_Force Support; JCA_8_Building Partnerships
Communities of Interest:
No COI(s) Identified
Descriptor(s):
*BURNS(INJURIES), *SKIN GRAFTS, CLINICAL MEDICINE, COLLAGEN, DAMAGE CONTROL, EPIDERMIS, EXPERIMENTAL DESIGN, FIBROSIS, GROWTH(PHYSIOLOGY), HAIR, HEALING, MEDICAL SUPPLIES, MORBIDITY, RATS, REGENERATION(PHYSIOLOGY), REPAIR, SILICON, STATISTICAL ANALYSIS, TRANSPLANTATION, TRAUMA
Field(s)/Group(s):
Anatomy and Physiology, Medicine and Medical Research, Medical Facilities, Equipment and Supplies
Keyword(s):
MCSG(MESHED COMPOSITE SKIN GRAFT), SNDC(SILVER NYLON AND DIRECT CURRENT), WOUND CLOSURE, EXCISION, AUTOGRAFT
Report Date:
2002 Jan 01
Creation Date:
2016 Mar 30