Skin burns can be catastrophic injuries, and often require multiple debridements and surgeries to achieve eventual skin regeneration. While...
Evolution of Dermal Substitute
Adequate soft-tissue coverage prior to excision of burned tissue is necessary in order to counteract the physiologic, metabolic and psychologic costs associated with burns. Early excision of burned tissue is the key factor in achieving optimal patient outcomes following a burn. Extensive burns often render little tissue available for graft donation, or patient factors may serve as a barrier to skin grafting. Dermal substitutes can act as a scaffold upon which eventual skin grafts can be placed. They serve to improve functional results in the acute phase of thermal injuries, and provide a matrix upon which dermis can be regenerated. Various sources of dermal allograft have been identified.
The Integra™ dermal substitute is an advanced, proprietary bilayer matrix which serves as a scaffold for dermal regeneration. It is composed of a mix of bovine cartilage and shark chondroitin. Once covered, re-epithelization can be expected in 2-3 weeks. At this point, half of the bilayer is removed, and a very thin split-thickness graft can be implanted. The immediate availability of the Integra™ product allows for implantation at time of debridement. It is a staged procedure however, and necessitates two trips to the operating room.