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Versatility of dermal regeneration templates in the treatment of burn sequelae

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

The management of burn sequelae is a major challenge for every plastic surgeon. The benefits of Integra® Dermal Regeneration Template in the management of burn injuries have been well documented but there is still a paucity of data regarding its use in reconstructive procedures. The aim of this study is to evaluate its effectiveness in the surgical treatment of post-burn scars.

Methods

We performed a retrospective review of burn patients with major burn sequelae treated with Integra® at our hospital during 2016–2017 period. A modified Vancouver Scar Scale (mVSS) was used to provide a more objective measurement of burn scars. All patients were submitted to a two-stage procedure. The first one consisted in complete excision of the lesions and implantation of Integra and the second one in resurfacing the neodermis with a split thickness skin graft.

Results

The average wound size covered with Integra was 741.6 cm2. Follow-up ranged from 9 to 16 months. There were no early complications. In all cases, we achieved satisfactory cosmetic results with significant improvements in functionality and quality of life. mVSS score post-op was significantly lower than pre-op in all patients.

Conclusions

Our results suggest that Integra is a very versatile tool for the treatment of burn sequelae. It yields good cosmetic and functional results in most cases with very little donor site morbidity. We believe that Integra should be viewed as one of the best current options for reconstructive procedures in burn patients.

Level of Evidence: Level IV, therapeutic study.

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References

  1. Yim H, Cho YS, Seo CH, Lee BC, Ko JH, Kim D, Hur J, Chun W, Kim JH (2010) The use of AlloDerm on major burn patients: AlloDerm prevents post-burn joint contracture. Burns 36:322–328

    Article  Google Scholar 

  2. Frame JD, Still J, Lakhel-LeCoadou A, Carstens MH, Lorenz C, Orlet H, Spence R, Berger AC, Dantzer E, Burd A (2004) Use of dermal regeneration template in contracture release procedures: a multicenter evaluation. Plast Reconstr Surg 113:1330–1338

    Article  Google Scholar 

  3. Stiefel D, Schiestl C, Meuli M (2010) Integra artificial skin for burn scar revision in adolescents and children. Burns 36:114–120

    Article  Google Scholar 

  4. Figus A, Leon-Villapalos J, Philp B, Dziewulski P (2007) Severe multiple extensive postburn contractures: a simultaneous approach with total scar tissue excision and resurfacing with dermal regeneration template. J Burn Care Res 28(6):913–917

    Article  Google Scholar 

  5. Hunt JA, Moisidis E, Haertsch P (2000) Initial experience of Integra in the treatment of post-burn anterior cervical neck contracture. Br J Plast Surg 53:652–658

    Article  CAS  Google Scholar 

  6. Dantzer E, Braye FM (2001) Reconstructive surgery using artificial dermis (Integra): results with 39 grafts. J Plast Reconstr Aesthet Surg 54:659–664

    CAS  Google Scholar 

  7. Muangman P, Engrav LH, Heimbach DM, Harunari N, Honari S, Gibran NS, Klein MB (2006) Complex wound management utilizing an artificial dermal matrix. Ann Plast Surg 57:199–202

    Article  CAS  Google Scholar 

  8. Kim SM, Choi JS, Lee JH, Kim YJ, Jun YJ (2014) Prevention of postsurgical scars: comparison of efficacy and convenience between silicone gel sheet and topical silicone gel. J Korean Med Sci 29:S249–S253

    Article  Google Scholar 

  9. Esselman PC, Thombs BD, Magyar-Russell G, Fauerbach JA (2006) Burn rehabilitation: state of the science. Am J Phys Med Rehabil 85:383–413

    Article  Google Scholar 

  10. Graham GP, Helmer SD, Haan JM, Khandelwal A (2013) The use of Integra® dermal regeneration template in the reconstruction of traumatic degloving injuries. J Burn Care Res 34(2):261–266

    Article  Google Scholar 

  11. Andrews JP, Marttala J, Macarak E, Rosenbloom J, Uitto J (2016) Keloids: the paradigm of skin fibrosis - pathomechanisms and treatment. Matrix Biol 51:37–46

    Article  CAS  Google Scholar 

  12. Chou TD, Chen SL, Lee TW, Chen SG, Cheng TY, Lee CH, Chen TM, Wang HJ (2001) Reconstruction of burn scar of the upper extremities with artificial skin. Plast Reconstr Surg 108:378–384

    Article  CAS  Google Scholar 

  13. Iwuagwu FC, Wilson D, Bailie F (1999) The use of skin grafts in postburn contracture release: a 10-year review. Plast Reconstr Surg 103:1198–1204

    Article  CAS  Google Scholar 

  14. Stern R, McPherson M, Longaker MT (1990) Histologic study of artificial skin used in the treatment of full-thickness thermal injury. J Burn Care Rehabil 11:7–13

    Article  CAS  Google Scholar 

  15. Bidic SM, Dauwe PB, Heller J, Brown S, Rohrich RJ (2012) Reconstructing large keloids with neodermis: a systematic review. Plast Reconstr Surg 129(2):380e–382e

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Hospital São José (Centro Hospitalar Lisboa Central), Lisbon, Portugal

    Luís Mata Ribeiro, Rafaela Serras, Ana Guerra, Nuno Maria, Joaquim Bexiga & Maria Manuel Mendes

  2. Department of Plastic and Reconstructive Surgery, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

    Íris Brito

Authors
  1. Luís Mata Ribeiro
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  2. Rafaela Serras
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  3. Íris Brito
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  4. Ana Guerra
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  5. Nuno Maria
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  6. Joaquim Bexiga
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  7. Maria Manuel Mendes
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Corresponding author

Correspondence to Luís Mata Ribeiro.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflicts of interest

Luís Mata Ribeiro, Rafaela Serras, Íris Brito, Ana Guerra, Nuno Maria, Joaquim Bexiga and Maria Manuel Mendes declare that they have no conflict of interest.

Informed consent

Informed consent for medical photographies and medical records was obtained from all individual participants included in the study.

Ethical approval

For this type of retrospective study formal consent from a local ethics committee is not required.

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Mata Ribeiro, L., Serras, R., Brito, Í. et al. Versatility of dermal regeneration templates in the treatment of burn sequelae. Eur J Plast Surg 42, 67–74 (2019). https://doi.org/10.1007/s00238-018-1446-8

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  • DOI: https://doi.org/10.1007/s00238-018-1446-8

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