This is a report of a prospective clinical trial performed in a single centre in Seoul, South Korea. The group attempted to observe the change in size of skin grafts applied to an artificial dermal substitute (matriderm). Two groups of patients were studied; those with acute burns and those with scars for reconstruction. Both groups had wounds created and reconstructed with a 1mm sheet of matriderm and a sheet graft placed on top which was hand fenestrated. A Visitrak digital pad was used to measure the area of the graft immediately postoperatively, then again monthly up to six months post operation.  Skin grafts on 31 body parts in 26 patients were measured. Their findings showed an average reduction in graft size by 11% at month one; 14% at month two; 18% at month three and 15% at month six – so an initial contraction in the graft and then a slight reversal towards the end, but it failed to return to its original immediate postoperative size. In their discussion, it is hypothesised that this latter finding of an improvement in contraction from three to six months occurs due to the maturation / remodelling phase of skin graft healing. Also in terms of skin contraction, acute burn injuries were found to have more contraction than those patients for scar reconstruction. The authors concluded that artificial dermis should be used around joints to minimise the overall potential for contraction compared to skin grafting alone.

Contracture of skin graft in human burns: effect of artificial dermis.
Hur G, Seo D, Lee J.
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Zeeshan Sheikh

NHS Lothian, UK

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