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Wound Healing Superior With Tissue-Engineered Skin Substitute
A DGReview of :"Evaluation of tissue-engineered skin (human skin substitute) and secondary intention healing in the treatment of full thickness wounds after mohs micrographic or excisional surgery."
Dermatologic Surgery
12/18/2002
By David Loshak
Human Skin Substitute appears to be a safe and well-tolerated biological dressing for full thickness wounds. Immunologically inert, it has equivalent co-morbid factors to secondary intention healing.
Human Skin Substitute (Apligraf, Organogenesis Inc., Canton, Massachusetts) seems to produce more pliable and less vascular scars than those developed through healing by secondary intention, say specialists at Northwestern University, The Feinberg School of Medicine, Chicago, Illinois.
They added that Human Skin Substitute also appeared to produce more satisfactory cosmetic results in the treatment of chronic and acute wounds than secondary intention healing.
The specialists explained that Human Skin Substitute is a bi-layered tissue-engineered living biological dressing developed from neonatal foreskin. It consists of a bovine collagen matrix containing human fibroblasts. Overlaying this matrix is an overlying sheet of stratified human epithelium containing living human keratinocytes.
To assess the safety and efficacy of Human Skin Substitute in wound treatment, the specialists studied 12 patients in a prospective case series.
Human Skin Substitute was applied in a blinded fashion to six patients immediately after Mohs micrographic surgery or excisional surgery for skin cancer. The other six patients were allowed to heal by secondary intention.
Both groups were evaluated weekly until re-epithelialisation was complete. At each evaluation, wound quality was assessed through the Vancouver Burn Scar Assessment Scale by the investigator and an independent blinded dermatologist. Both they and patients further evaluated cosmetic outcomes with a Visual Analogue Scale over six months.
The two groups were equivalent in co-morbid factors such as pain, erythema, oedema, exudate, infection and haematoma. Wounds healed at similar rates and was complete at six months in all 12 patients. Patient satisfaction with cosmetic outcome was positive in both groups.
Dermatologic Surgery 2002;28(12):1107-1114.
"Evaluation of tissue-engineered skin (human skin substitute) and secondary intention healing in the treatment of full thickness wounds after mohs micrographic or excisional surgery."
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