Clinical use of acellular allogenic dermis or acellular porcine dermis with split-thickness autologous skin graft in 119 cases

Abstract:  OBJECTIVE: To observe the effect of acellular allogenic dermis or acellular porcine dermis together with split-thickness autologous skin graft on coverage of deep burn wound and the wound of scar excision. METHODS: Acellular allogenic dermis or acellular porcine dermis produced by our unit, with split-thickness autologous skin graft, were used in repairing various wounds in 119 cases. The take rate of various wounds was compared, and the take rate of wounds in which autologous skin from different sites was used to cover either acellular allogenic dermis or acellular porcine dermis was also compared. Histological examination and follow-up were made in some cases. RESULTS: After tangential excision, eschar excision and scar excision, the wounds were covered with either allogenic acellular dermis or porcine acellular dermis and autologous split-thickness skin. The take rate was found to be (93.4 +/- 3.4)%, (92.1 +/- 4.6)%, (94.5 +/- 3.5)%, respectively. There was no a significant difference in take rate (P > 0.05). No significant difference in take rate between the transplantation of allogenic acellular dermis with autologous split-thickness skin and transplantation of porcine acellular dermis with autologous split-thickness skin was found (P > 0.05). When autologous split-thickness skin harvested from the trunk or extremities was used, the take rate was (93.1 +/- 4.8)%, (89.0 +/- 6.2)%, respectively, whereas the take rate was only about 70% - 80% when skin harvested from the scalp was used. The take rate was only about 40% when acellular allogenic dermis and autologous micro-skin graft were used to cover the wound. Histological examination 19 months after the transplantation revealed normal structure. Collagenous fibers were orderly arranged. There was no apparent hyperplasia of collagenous fibers. Hair follicles, sweat glands and other skin appendages were not found in the healed area. Grossly, no obvious pigmentation was seen, the surface was smooth with slight wound contraction, and the consistency was flexible. CONCLUSION: Acellular allogenic split-thickness dermis or acellular porcine split-thickness dermis with autologous split-thickness dermis for coverage of deep burn wound and the wound of scar excision is an ideal material.