[Clinical application and long-term follow-up study of acellular dermal matrix combined with auto-skin grafting].

OBJECTIVE: To investigate the clinical effect of acellular dermal matrix (ADM) combined with auto-skin grafting on deep burn wound ,and the result of long-term follow-up and histological examination. METHODS: One hundred and fifty-two patients with deep burn hospitalized from February 2000 to July 2003 were repaired with porcine ADM and auto split-thickness graft. Wound healing rate was assessed 1 week after operation. Degree of cicatricial hyperplasia was examined 1, 3, 6, 12 months after operation. Wound samples from 5 patients were harvested for histological examination 72 months after operation, for which transmission electron microscopy were employed in 2 cases. RESULTS: Grafts completely survived was seen in 116 patients (accounting for 76.3% of cases), survival rate over 95% were observed in 23.7% of cases. One hundred and twenty-seven patients were followed up 1 month after operation, in whom mild local contraction, cord like scar was seen along its junction with skin, its texture was soft ,and there was no pruritus or blister formation. One hundred and one patients were followed up 3 months after operation, and the graft showed mild contraction less marked when compared with that of the site where auto split-thickness skin grafting was used. Articular function was good. Eighty-two patients were followed up 6 months after operation,color and texture of grafts were similar to normal skin with no obvious cicatricial hyperplasia. Fifty-eight patients were followed up 12 months after operation, the texture of grafts was similar to normal skin without obvious reject reaction. Sixteen patients were followed up over 72 months after operation, the grafts appeared dry compared with normal skin. Histological examination showed: tissue structure of grafts was similar to normal skin, intact small sweat gland and sweat gland cells were not found in dermal layer. CONCLUSION: Heterologous ADM combined with auto split-thickness graft can survive in human body without obvious immune rejection reaction for a long time. No intact small sweat gland or sweat gland cells in dermis is a problem worth of study in regeneration of skin function.

[Treatment of deep partial thickness burns by a single dressing of porcine acellular dermal matrix].

OBJECTIVE: To explore the effect of one dressing of porcine acellular dermal matrix on deep partial thickness burns. METHODS: From January 1997 to January 2004, sixty-seven cases of deep partial thickness total burned surface area (TBSA) from 50% to 90% burn wound were treated by a single dressing of porcine acellular dermal matrix (the porcine acellular dermal matrix group). Ten cases of deep partial thickness burned patients with the same TBSA treated by exposure method served as the exposure method group. The healing time of the wound was observed. The patients were followed up for 3 months to 2 years, and the scar proliferation was observed. RESULTS: The deep partial-thickness wound would be healed without dressing change in the porcine acellular dermal matrix group, and the average healing time was (12.2 +/- 2.6) days. The average healing time of the exposure method group was (27.4 +/- 3.5) days. Follow up of the patients within 3 months to 2 years showed that scar proliferation in the porcine acellular dermal matrix group was much less than that in the exposure method group, even no scar proliferation was observed in some patients. CONCLUSION: Without tangential excision, autografting and dressing change, a single dressing of porcine acellular dermal matrix on deep partial thickness burn wound could shorten the healing time and inhibit scar proliferation.

[The volume change of micronized acellular dermal matrix after injection].

OBJECTIVE: To explore a new injectable material. METHODS: Micronized swine acellular dermal matrix was injected into the ear of rabbits. The augmentation was observed and measured with pathological and transmission electron microscopic technique. RESULTS: There were fibroblasts and capillaries in the injected material. The absorption rate of injected acellular dermal matrix was 26.93% in the experimental group at 48 weeks after injection. CONCLUSION: The acellular dermal matrix is an ideal injectable material for lower absorption and easy usage.

[Porcine acellular dermal matrix in the treatment of deep partial-thickness burns in human].

OBJECTIVE: To investigate the possibility of treating deep partial-thickness burns by closed dressing of the wounds with porcine acellular dermal matrix (ADM) and evaluate the therapeutic effects. METHODS: We conducted a retrospective review of 128 cases of burn patients who received treatment with porcine ADM within the period from January 1998 to January 2002 in our hospital. Different procedures were adopted according to the degree of the burn injury. As for "fairly superficial" deep partial-thickness skin burns, after removing the necrotic epidermis and washing with 0.1 % benzalkonium bromide, the wound was covered with porcine ADM pretreated with povidone-iodine and then bandaged with cotton gauze and bandages. In cases of "fairly deep" deep partial skin thickness burns, eschar excisions as deep as to expose parabiotic lamina were performed prior to dressing the wounds in the same manner as described above. RESULTS: All the patients were successfully treated with satisfactory clinical results. CONCLUSIONS: Porcine ADM is feasible as an efficient dressing material for deep partial-thickness burns, which may promote epithelialization in the wounds and help stabilize the patients' condition during burn shock stage to reduce the complications and shorten the treatment courses.