The use of dermal substitutes in burn surgery: Acute phase

Abstract

Dermal substitutes are increasingly becoming an essential part of the burn care strategy. During the acute phase of burn treatment, dermal substitutes improve functional and cosmetic results long-term and thus increase quality of life. In the chronic wound setting, dermal substitutes are used to reconstruct and improve burn scars and other defects. Despite some successes in the use of dermal substitutes there are more needs and requirements to further improve outcomes and hence further research is required not only to strengthen scientific evidence regarding their effects but also to develop new technology and products. Dermal substitutes also emerge as pivotal research strategies to develop adequate scaffolds for stem cells, tissue engineering and regenerative medicine applications to obtain long-lasting and scarless artificial skin. This review discusses status-quo of dermal substitutes and novel strategies in the use of dermal substitutes with a focus on burn care.

Uncultured adipose-derived regenerative cells (ADRCs) seeded in collagen scaffold improves dermal regeneration, enhancing early vascularization and structural organization following thermal burns

“…For deep and extensive burns the use of conventional surgical techniques, such as autologous split thickness skin grafting is limited by donor site availability, frequently requiring the use of skin substitutes or temporary coverage with allogeneic or xenogeneic grafts. Numerous advances in tissue engineering have yielded a range of both natural and synthetic skin substitutes with applications for burns, diabetic wounds, ulcers and tissue reconstruction [2,3]. Importantly long-term viability of tissueengineered skin substitutes requires the formation of neovessels allowing survival and integration after implantation [4].…”

Cellularized Bilayer Pullulan-Gelatin Hydrogel for Skin Regeneration

“…3 These include complications due to highly inflammatory wounds, poor skin regeneration, and high costs. 1,[3][4][5] This leads to adverse events causing potential death, poor aesthetic and functional outcomes, and expensive treatments. Thus, further research into the creation of skin substitutes that solve these challenges is needed.…”

Potentials and limitations of Integra® flowable wound matrix seeded with adipose tissue-derived microvascular fragments

“…For this purpose, several bioengineered matrices have been developed as off-the-shelf dermal skin substitutes, such as Integra ® , Matriderm ® or Glyaderm ® (Pirayesh et al, 2014;Shahrokhi et al, 2014). In the initial phase of treatment, these matrices are directly implanted into the debrided wound bed, where they provide the required porous structure to allow cellular and vascular ingrowth from the surrounding tissue until the final coverage with split-thickness skin (Debels et al, 2015).…”