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Long-Term Clinical and Histological Evaluation of PoreSkin: A Human Acellular Dermal Matrix in Burn Scars, a Descriptive Clinical Study

Apichai Angspatt MD1, Akom Thongchompu MD1, Tanom Bunaprasert MD2, Voranuch Thanakit MD3

Affiliation : 1 Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand 2 Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand 3 Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Background : PoreSkin, a (cid:976)irst 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 split- thickness skin grafting is 44.6% (22.8% to 55.9%). Scar quality is signi(cid:976)icantly improved according to Vancouver scar scale. Histological (cid:976)inding showed no in(cid:976)lammatory cells, normal capillary formation, increased (cid:976)ibroblast, and collagen proliferation; however, most of them were in disorganized pattern.
Conclusion : The long-term result of PoreSkin reconstruction as a dermal substitute showed signi(cid:976)icant improvements in grafted area scar quality. Substantial area of contraction had occurred. Normal capillary formation was identi(cid:976)ied. Increased (cid:976)ibroblast and collagen proliferation although in disorganized arrangement were presented in all specimens. No in(cid:976)lammatory cell was found.

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


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MEDICAL ASSOCIATION OF THAILAND
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