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A novel technique of reducing full-thickness skin graft contraction using a dermal substitute: an animal model study

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Full-thickness skin grafts (FTSG) are clinically utilised in settings to minimize contraction. However, FTSG contraction can have significant functional and aesthetical implications in reconstruction, particularly in head and neck cases and burns patients. This study was designed to establish a mouse model for studying the inhibitory effect of dermal substitutes on FTSG contraction. Secondarily, the model quantitatively assessed the specific effect of Integra™ on FTSG contraction and examined if Integra™ can be used in a single-stage procedure with a FTSG.

Methods

Eighteen male Wistar mice had a quadrangular 3 × 2 cm full-thickness skin defect produced on their back and divided into two groups. In the first group, the graft obtained from the defect was sutured back down as a FTSG. In the second group, Integra™ was placed under 30% of the FTSG in a grid pattern to allow vascular perfusion of the skin, in a single-stage procedure. Graft contraction in the two groups was accurately measured over a set time frame.

Results

The difference of wound contraction in week 1 was not statistically significant; however, the differences increased dramatically after week 1 as the Integra™ was vascularized. This difference became statistically significant at week 2 (p < 0.05), week 3 (p < 0.01) and week 4 (p < 0.01). By week 3, a significant 17% difference in graft contraction was seen and the difference in contraction remained stationary in week 4 (at 18%).

Conclusions

The application of a split dermal template resulted in a significant decrease in FTSG contraction. Additionally, Integra™ was observed to be successfully utilised with a FTSG in a single-stage procedure. This technique could be utilised in an effort to reduce graft contraction in complicated sites.

Level of evidence

All experimental studies are not ratable.

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Funding

This work was supported by a grant from the ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia (NHMRC grant GNT9000309).

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Authors and Affiliations

  1. Plastic & Reconstructive Surgery Research, ANZAC Research Institute, University of Sydney, Sydney, Australia

    Charles Meares, Vlad Illie, Li Zhe & Peter Maitz

  2. Darlinghurst, Australia

    Charles Meares

  3. Burns Unit, Concord Hospital, Concord, NSW, 2139, Australia

    Li Zhe & Peter Maitz

Authors
  1. Charles Meares
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  2. Vlad Illie
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  3. Li Zhe
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  4. Peter Maitz
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Corresponding author

Correspondence to Charles Meares.

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Conflict of interest

Charles Meares, Vlad Illie, Li Zhe, and Peter Maitz declare that they have no conflict of interest.

Ethical approval

Approval obtained from the ANZAC Research Institute and all animal procedures were performed in accordance with the guidelines issued by the Intramural Research Program of the National Institutes of Health protocol number 444TGB2016

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Meares, C., Illie, V., Zhe, L. et al. A novel technique of reducing full-thickness skin graft contraction using a dermal substitute: an animal model study. Eur J Plast Surg 43, 535–540 (2020). https://doi.org/10.1007/s00238-020-01661-9

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  • DOI: https://doi.org/10.1007/s00238-020-01661-9

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