Comparative long-term study between two dermal regeneration templates for the reconstruction of burn scar contractures in humans: Clinical and histological results

Abstract

The advent of dermal regeneration templates has fostered major advances in the treatment of acute bums and their sequelae, in the last three decades. Both data on morphological aspects of the newly-formed tissue, and clinical trials comparing different templates, are few. The goal of this study was to prospectively analyze the outcome of randomized patients treated with two of the existing templates, followed by thin skin autograft. They are both 2mm-thick bovine collagen templates (Matriderm (R) and Integra (R)), the latter includes a superficial silicone layer. Surgery was performed on patients with impaired mobility resulting from bum sequelae (n =12 per template) in a two-step procedure. Negative pressure therapy was applied after surgery; patients were monitored for 12 months. No infra or postoperative complications were observed. Data on scar skin quality (Vancouver scar scale), rate of mobility recovery, and graft contraction were recorded; as well as morphological analyses at light microscopical level. Improvement in mobility and skin quality were demonstrated along with graft contraction, in all patients. The double layer template showed the best performance in retraction rate, skin quality and mobility recovery. The subepidermal newly-formed connective tissue showed no histoarchitectural differences between the templates. The double layer template was not absorbed up to 12 months after placement.