Clinical effectiveness of dermal substitution in burns by topical negative pressure: A multicenter randomized controlled trial

Previous research has shown clinical effectiveness of dermal substitution; however, in burn wounds, only limited effect has been shown. A problem in burn wounds is the reduced take of the autograft, when the substitute and graft are applied in one procedure. Recently, application of topical negative...

Full description

Saved in:
Bibliographic Details
Published in:Wound repair and regeneration 2012-11, Vol.20 (6), p.797-805
Main Authors: Bloemen, Monica C. T., van der Wal, Martijn B. A., Verhaegen, Pauline D. H. M., Nieuwenhuis, Marianne K., van Baar, Margriet E., van Zuijlen, Paul P. M., Middelkoop, Esther
Format: Article
Language:English
Subjects:
Adult
Burns - microbiology
Burns - pathology
Burns - surgery
Cicatrix - microbiology
Cicatrix - pathology
Elasticity
Esthetics
Female
Graft Survival
Humans
Male
Middle Aged
Negative-Pressure Wound Therapy
Pain Measurement
Prospective Studies
Skin Transplantation - methods
Skin, Artificial
Wound Healing
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Previous research has shown clinical effectiveness of dermal substitution; however, in burn wounds, only limited effect has been shown. A problem in burn wounds is the reduced take of the autograft, when the substitute and graft are applied in one procedure. Recently, application of topical negative pressure (TNP) was shown to improve graft take. The aim of this study was to investigate if application of a dermal substitute in combination with TNP improves scar quality after burns. In a four‐armed multicenter randomized controlled trial, a split‐skin graft with or without a dermal substitute and with or without TNP was compared in patients with deep dermal or full‐thickness burns requiring skin transplantation. Graft take and rate of wound epithelialization were evaluated. Three and 12 months postoperatively, scar parameters were measured. The results of 86 patients showed that graft take and epithelialization did not reveal significant differences. Significantly fewer wounds in the TNP group showed postoperative contamination, compared to other groups. Highest elasticity was measured in scars treated with the substitute and TNP, which was significantly better compared to scars treated with the substitute alone. Concluding, this randomized controlled trial shows the effectiveness of dermal substitution combined with TNP in burns, based on extensive wound and scar measurements.
ISSN:1067-1927
1524-475X
DOI:10.1111/j.1524-475X.2012.00845.x