Background: PoreSkin, a first and only human acellular dermal matrix [hADM] developed in Thailand, has been reported to have a satisfactory engraftment rate without any signs of rejection or any other complications in the treatment of burn scars. Although a previous study had demonstrated the favorable short-term clinical results, the long-term clinical, and histological results should be evaluated.

Objective: To assess the long-term clinical and histological results in burn scars treated with PoreSkin for more than 18 months.

Materials and Methods: Ten patients with burn scar deformities had been treated with PoreSkin placement and subsequent delayed thin split-thickness skin grafting for more than 18 months were enrolled in the present study. Percentage of scar contraction was measured using the standard graph paper technique. Vancouver scar scale was used to evaluate the improvement of the scar quality. Punch biopsy specimens from the grafted area were taken for light and electron microscopic examination.

Results: After 18 months, the mean contraction percentage of the area treated with PoreSkin and subsequent delayed thin splitthickness skin grafting is 44.6% (22.8% to 55.9%). Scar quality is significantly improved according to Vancouver scar scale. Histological finding showed no inflammatory cells, normal capillary formation, increased fibroblast, and collagen proliferation; however, most of them were in disorganized pattern.

Conclusion: The long-term result of PoreSkin reconstruction as a dermal substitute showed significant improvements in grafted area scar quality. Substantial area of contraction had occurred. Normal capillary formation was identified. Increased fibroblast and collagen proliferation although in disorganized arrangement were presented in all specimens. No inflammatory cell was found.

Keywords: Burns, Acellular dermal matrix, Acellular dermal regeneration template, Dermal substitute, Wound healing