Advertisement

Pediatric Surgery International

, Volume 28, Issue 2, pp 171–177 | Cite as

Matriderm® 1 mm versus Integra® Single Layer 1.3 mm for one-step closure of full thickness skin defects: a comparative experimental study in rats

  • Sophie Böttcher-Haberzeth
  • Thomas Biedermann
  • Clemens Schiestl
  • Fabienne Hartmann-Fritsch
  • Jörg Schneider
  • Ernst Reichmann
  • Martin Meuli
Original Article

Abstract

Purpose

Dermal templates, such as Matriderm® and Integra®, are widely used in plastic and reconstructive surgery, often as two-step procedures. A recent development is the application of thin dermal templates covered with split thickness skin grafts in one-step procedures. In this experimental study, we compare the two thin matrices Matriderm® 1 mm and Integra® Single Layer in a one-step procedure with particular focus on neodermis formation.

Methods

Matriderm® 1 mm and Integra® Dermal Regeneration Template—Single Layer (1.3 mm) were compared in a rat model. In three groups of five animals each, a full thickness wound was covered with (a) Matriderm® 1 mm and neonatal rat epidermis, (b) Integra® Single Layer and neonatal rat epidermis, or, (c) neonatal rat epidermis only (control). Histological sections 2 weeks post transplantation were analyzed with regard to take of template and epidermis, neodermal thickness, collagen deposition, vascularization, and inflammatory response.

Results

Take of both templates was complete in all animals. The Matriderm®-based neodermis was thinner but showed a higher cell density than the Integra®-based neodermis. The other parameters were similar in both matrices.

Conclusion

The two templates demonstrate a comparable biological behavior early after transplantation. The only difference was found regarding neodermal thickness, probably resulting from faster degradation of Matriderm®. These preliminary data suggest that both dermal templates appear similarly suitable for transplantation in a one-step procedure.

Keywords

Dermal substitute Matriderm® 1 mm Integra® Single Layer One-step procedure Rat model 

Notes

Acknowledgments

This work was financially supported by EU-FP6 project EuroSTEC (soft tissue engineering for congenital birth defects in children: contract: LSHB-CT-2006-037409) and by the University of Zurich. We are particularly grateful to the Foundation Gaydoul and the sponsors of “DonaTissue” (Thérèse Meier, Robert Zingg, the Vontobel Foundation, and the Werner Spross Foundation) for their generous financial support and interest in our work.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Abbas Khan MA, Chipp E, Hardwicke J, Srinivasan K, Shaw S, Rayatt S (2010) The use of Dermal Regeneration Template (Integra®) for reconstruction of a large full-thickness scalp and calvarial defect with exposed dura. J Plast Reconstr Aesthet Surg 63(12):2168–2171PubMedCrossRefGoogle Scholar
  2. 2.
    Böttcher-Haberzeth S, Biedermann T, Reichmann E (2010) Tissue engineering of skin. Burns 36(4):450–460PubMedCrossRefGoogle Scholar
  3. 3.
    Schiestl C, Stiefel D, Meuli M (2010) Giant naevus, giant excision, eleg(i)ant closure? Reconstructive surgery with Integra Artificial Skin to treat giant congenital melanocytic naevi in children. J Plast Reconstr Aesthet Surg 63(4):610–615PubMedCrossRefGoogle Scholar
  4. 4.
    Schiestl C, Neuhaus K, Biedermann T, Böttcher-Haberzeth S, Reichmann E, Meuli M (2011) Novel treatment for massive lower extremity avulsion injuries in children: slow, but effective with good cosmesis. Eur J Pediatr Surg 21(2):106–110PubMedCrossRefGoogle Scholar
  5. 5.
    Stiefel D, Schiestl CM, Meuli M (2009) The positive effect of negative pressure: vacuum-assisted fixation of Integra artificial skin for reconstructive surgery. J Pediatr Surg 44(3):575–580PubMedCrossRefGoogle Scholar
  6. 6.
    Stiefel D, Schiestl C, Meuli M (2010) Integra Artificial Skin for burn scar revision in adolescents and children. Burns 36(1):114–120PubMedCrossRefGoogle Scholar
  7. 7.
    van der Veen VC, van der Wal MB, van Leeuwen MC, Ulrich MM, Middelkoop E (2010) Biological background of dermal substitutes. Burns 36(3):305–321PubMedCrossRefGoogle Scholar
  8. 8.
    Weigert R, Choughri H, Casoli V (2010) Management of severe hand wounds with Integra® dermal regeneration template. J Hand Surg Eur 36(3):185–193CrossRefGoogle Scholar
  9. 9.
    Atherton DD, Tang R, Jones I, Jawad M (2010) Early excision and application of Matriderm with simultaneous autologous skin grafting in facial burns. Plast Reconstr Surg 125(2):60e–61ePubMedCrossRefGoogle Scholar
  10. 10.
    Cervelli V, Lucarini L, Cerretani C, Spallone D, Palla L, Brinci L, De Angelis B (2010) The use of Matriderm and autologous skin grafting in the treatment of diabetic ulcers: a case report. Int Wound J 7(4):291–296PubMedCrossRefGoogle Scholar
  11. 11.
    Cervelli V, Brinci L, Spallone D, Tati E, Palla L, Lucarini L, De Angelis B (2011) The use of Matriderm(®) and skin grafting in post-traumatic wounds. Int Wound J 8(4):400–405PubMedCrossRefGoogle Scholar
  12. 12.
    Greenwood JE, Mackie IP (2011) Neck contracture release with Matriderm collagen/elastin dermal matrix. Eplasty 22(11):e16Google Scholar
  13. 13.
    Haslik W, Kamolz LP, Nathschläger G, Andel H, Meissl G, Frey M (2007) First experiences with the collagen-elastin matrix Matriderm as a dermal substitute in severe burn injuries of the hand. Burns 33(3):364–368PubMedCrossRefGoogle Scholar
  14. 14.
    Haslik W, Kamolz LP, Manna F, Hladik M, Rath T, Frey M (2010) Management of full-thickness skin defects in the hand and wrist region: first long-term experiences with the dermal matrix Matriderm. J Plast Reconstr Aesthet Surg 63(2):360–364PubMedCrossRefGoogle Scholar
  15. 15.
    Heckmann A, Radtke C, Rennekampff HO, Jokuszies A, Weyand B, Vogt PM (2011) One-stage defect closure of deperiosted bone and exposed tendons with Matriderm® and skin transplantation: possibilities and limitations. Unfallchirurg May 15 [Epub ahead of print] GermanGoogle Scholar
  16. 16.
    Ryssel H, Gazyakan E, Germann G, Ohlbauer M (2008) The use of Matriderm in early excision and simultaneous autologous skin grafting in burns–a pilot study. Burns 34(1):93–97PubMedCrossRefGoogle Scholar
  17. 17.
    Ryssel H, Radu CA, Germann G, Otte M, Gazyakan E (2010) Single-stage Matriderm® and skin grafting as an alternative reconstruction in high-voltage injuries. Int Wound J 7(5):385–392PubMedCrossRefGoogle Scholar
  18. 18.
    Ryssel H, Germann G, Kloeters O, Gazyakan E, Radu CA (2010) Dermal substitution with Matriderm(®) in burns on the dorsum of the hand. Burns 36(8):1248–1253PubMedCrossRefGoogle Scholar
  19. 19.
    van Zuijlen PP, van Trier AJ, Vloemans JF, Groenevelt F, Kreis RW, Middelkoop E (2000) Graft survival and effectiveness of dermal substitution in burns and reconstructive surgery in a one-stage grafting model. Plast Reconstr Surg 106(3):615–623PubMedCrossRefGoogle Scholar
  20. 20.
    Branski LK, Herndon DN, Pereira C, Mlcak RP, Celis MM, Lee JO, Sanford AP, Norbury WB, Zhang XJ, Jeschke MG (2007) Longitudinal assessment of Integra in primary burn management: a randomized pediatric clinical trial. Crit Care Med 35(11):2615–2623PubMedCrossRefGoogle Scholar
  21. 21.
    Moiemen N, Yarrow J, Hodgson E, Constantinides J, Chipp E, Oakley H, Shale E, Freeth M (2011) Long-term clinical and histological analysis of Integra dermal regeneration template. Plast Reconstr Surg 127(3):1149–1154PubMedCrossRefGoogle Scholar
  22. 22.
    Fusenig NE, Breitkreutz D, Dzarlieva RT, Boukamp P, Bohnert A, Tilgen W (1983) Growth and differentiation characteristics of transformed keratinocytes from mouse and human skin in vitro and in vivo. J Invest Dermatol 81:168s–175sPubMedCrossRefGoogle Scholar
  23. 23.
    Schneider J, Biedermann T, Widmer D, Montano I, Meuli M, Reichmann E, Schiestl C (2009) Matriderm versus Integra: a comparative experimental study. Burns 35(1):51–57PubMedCrossRefGoogle Scholar
  24. 24.
    Koenen W, Felcht M, Vockenroth K, Sassmann G, Goerdt S, Faulhaber J (2011) One-stage reconstruction of deep facial defects with a single layer dermal regeneration template. J Eur Acad Dermatol Venereol 25(7):788–793PubMedCrossRefGoogle Scholar
  25. 25.
    Yannas IV, Burke JF, Gordon PL, Huang C, Rubenstein RH (1980) Design of an artificial skin. II. Control of chemical composition. J Biomed Mater Res 14:107–132PubMedCrossRefGoogle Scholar
  26. 26.
    McKegney M, Taggart I, Grant MH (2001) The influence of crosslinking agents and diamines on the pore size, morphology and the biological stability of collagen sponges and their effect on cell penetration through the sponge matrix. J Mater Sci Mater Med 12:833–844PubMedCrossRefGoogle Scholar
  27. 27.
    Gobet R, Raghunath M, Altermatt S, Meuli-Simmen C, Benathan M, Dietl A, Meuli M (1997) Efficacy of cultured epithelial autografts in pediatric burns and reconstructive surgery. Surgery 121(6):654–661PubMedCrossRefGoogle Scholar
  28. 28.
    Meuli M, Raghunath M (1997) Burns (Part 2). Tops and flops using cultured epithelial autografts in children. Pediatr Surg Int 12(7):471–477PubMedGoogle Scholar
  29. 29.
    Raghunath M, Meuli M (1997) Cultured epithelial autografts: diving from surgery into matrix biology. Pediatr Surg Int 12(7):478–483PubMedCrossRefGoogle Scholar
  30. 30.
    Adams DC, Ramsey ML (2005) Grafts in dermatologic surgery: review and update on full- and split-thickness skin grafts, free cartilage grafts, and composite grafts. Dermatol Surg 31(8 Pt 2):1055–1067 (Review)PubMedGoogle Scholar
  31. 31.
    Muller MJ, Nicolai M, Wiggins R, MacGill K, Herndon DN (1996) Modern treatment of a burn wound. In: Herndon DN (ed) Total Burn Care. Saunders, London, pp 136–147Google Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Sophie Böttcher-Haberzeth
    • 1
    • 2
  • Thomas Biedermann
    • 1
  • Clemens Schiestl
    • 2
  • Fabienne Hartmann-Fritsch
    • 1
  • Jörg Schneider
    • 3
  • Ernst Reichmann
    • 1
  • Martin Meuli
    • 2
  1. 1.Department of Surgery, Tissue Biology Research UnitUniversity Children’s Hospital ZurichZurichSwitzerland
  2. 2.Department of Surgery, Pediatric Burn Center, Plastic and Reconstructive SurgeryUniversity Children’s Hospital ZurichZurichSwitzerland
  3. 3.Department of SurgeryHospital FrauenfeldFrauenfeldSwitzerland

Personalised recommendations