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Clinical Outcome of Cryopreserved Acellular Dermal Matrix for Full-Thickness Burns

Abstract

This study aimed at identifying properties of cryopreserved acellular dermal matrix (CPADM) and evaluating its effectiveness in the treatment of burn patients. The prospective study included 50 patients who received split-thickness skin grafts with CPADM over joints between January 2010 and July 2012. From June to October 2014, a total of 11 patients revisited our burn clinic for evaluation of the range of motion (ROM) of the joints in the involved areas. Additionally, an assessment of the condition of the grafted skin was made with regard to skin elasticity, transepidermal water loss (TEWL), and melanin and erythema levels. 19 of 50 patients who received CPADM and 31 of the 64 patients who received a freeze-dried acellular dermal matrix (FDADM) agreed to undergo analysis of the conditions of their scars. The CPADM was introduced in 2009. It was created using a controlled-rate freezer with a cryopreservation solution and was evaluated with regard to its tensile strengths and angiogenic factor release. In all, 53.8% of patients who had received the CPADM application had no ROM limitations afterwards. The TEWL in the CPADM-grafted areas was similar to that in normal skin; however, there was significantly less elasticity and higher melanin and erythema values in the grafted areas than in normal skin. Application of CPADM was more effective than that of FDADM in terms of scar thickness, elasticity, and TEWL levels (0.13±0.04 vs. 0.2±0.1 cm, 0.67±0.27 vs. 0.456±0.48 mm, and 16.2±6.8 vs. 12.1±5.3 g/h/m2, respectively). Therefore, the CPADM for split-thickness skin grafts is a safe and effective dermal replacement for one-stage surgery in patients with acute burns.

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References

  1. (1)

    R. Papini, BMJ, 329, 158 (2004).

    Article  PubMed  PubMed Central  Google Scholar 

  2. (2)

    R. V. Shevchenko, S. L. James, and S. E. James, J. R. Soc. Interface, 7, 229 (2010).

    Article  CAS  PubMed  Google Scholar 

  3. (3)

    C. Blanpain, W. E. Lowry, A. Geoghegan, L. Polak, and E. Fuchs, Cell, 118, 635 (2004).

    Article  CAS  PubMed  Google Scholar 

  4. (4)

    C.-H. Fang, E. C. Robb, G.-S. Yu, J. W. Alexander, and G. D. Warden, J. Burn Care Res., 11, 538 (1990).

    Article  CAS  Google Scholar 

  5. (5)

    H. C. Grillo and C. F. McKhann, Transplantation, 2, 48 (1964).

    Article  CAS  PubMed  Google Scholar 

  6. (6)

    H. Ben-Bassat, A. Eldad, M. Chaouat, A. Livoff, N. Ron, Z. Ne’eman, and M. R. Wexler, Plast. Reconstr. Surg., 89, 510 (1992).

    Article  CAS  PubMed  Google Scholar 

  7. (7)

    D. A. Medalie, S. A. Eming, R. G. Tompkins, M. L. Yarmush, G. G. Krueger, and J. R. Morgan, J. Invest. Dermatol., 107, 121 (1996).

    Article  CAS  PubMed  Google Scholar 

  8. (8)

    D. A. Medalie, R. G. Tompkins, and J. R. Morgan, ASAIO J., 42, M455 (1996).

    Article  CAS  PubMed  Google Scholar 

  9. (9)

    N. H. Kang, S. M. Choi, S. H. Oh, J. H. Ahn, J. Y. Kim, and D. M. Choi, Tissue Eng. Reg. Med., 6, 659 (2009).

    Google Scholar 

  10. (10)

    R. J. Walter, T. Matsuda, H. M. Reyes, J. M. Walter, and M. Hanumadass, Burns, 24, 104 (1998).

    Article  CAS  PubMed  Google Scholar 

  11. (11)

    C. R. Baxter and T. Shires, Ann. N. Y. Acad. Sci., 150, 874 (1968).

    Article  CAS  PubMed  Google Scholar 

  12. (12)

    P. Van Zuijlen, A. P. Angeles, R. W. Kreis, K. E. Bos, and E. Middelkoop, Plast. Reconstr. Surg., 109, 1108 (2002).

    Article  PubMed  Google Scholar 

  13. (13)

    G. V. Oliveira, D. Chinkes, C. Mitchell, G. Oliveras, H. K. Hawkins, and D. N. Herndon, Dermatol. Surg., 31, 48 (2005).

    Article  CAS  PubMed  Google Scholar 

  14. (14)

    T. D. Kang, K. E. Jang, D. S. Park, S. B. Kim, and E. H. Jung, J. Korean Acad. Rehabil. Med., 23, 397 (1999).

    Google Scholar 

  15. (15)

    W. Cheng, H. Saing, H. Zhou, Y. Han, W. Peh, and P. Tam, J. Pediatr. Surg., 36, 466 (2001).

    Article  CAS  PubMed  Google Scholar 

  16. (16)

    J. Hambleton, P. Shakespeare, and B. Pratt, Burns, 18, 301 (1992).

    Article  CAS  PubMed  Google Scholar 

  17. (17)

    G. Pettet, M. A. Chaplain, D. McElwain, and H. Byrne, Proc. R. Soc. Lond. B: Biol. Sci., 263, 1487 (1996).

    Article  CAS  Google Scholar 

  18. (18)

    M. G. Tonnesen, X. Feng, and R. A. Clark, J. Investig. Dermatol. Symp. Proc., 5, 40 (2000).

    Article  CAS  PubMed  Google Scholar 

  19. (19)

    J. Folkman and M. Klagsbrun, Science, 235, 442 (1987).

    Article  CAS  PubMed  Google Scholar 

  20. (20)

    J. F. Roesel and L. B. Nanney, J. Surg. Res., 58, 449 (1995).

    Article  CAS  PubMed  Google Scholar 

  21. (21)

    N. Brusselaers, E. A. Hoste, S. Monstrey, K. E. Colpaert, J. J. De Waele, K. H. Vandewoude, and S. I. Blot, Intensive Care Med., 31, 1648 (2005).

    Article  PubMed  Google Scholar 

  22. (22)

    J. P. Barret and D. N. Herndon, Plast. Reconstr. Surg., 111, 744 (2003).

    Article  PubMed  Google Scholar 

  23. (23)

    S. Blot, Br. J. Surg., 96, 111 (2008).

    Google Scholar 

  24. (24)

    N. Brusselaers, I. Juhász, I. Erdei, S. Monstrey, and S. Blot, Burns, 35, 1009 (2009).

    Article  CAS  PubMed  Google Scholar 

  25. (25)

    F. Grinnell, J. Cell Biol., 124, 401 (1994).

    Article  CAS  PubMed  Google Scholar 

  26. (26)

    A. van den Bogaerdt, P. van Zuijlen, M. Van Galen, E. Lamme, and E. Middelkoop, Arch. Dermatol. Res., 294, 135 (2002).

    Article  PubMed  Google Scholar 

  27. (27)

    N. Brusselaers, C. Lafaire, S. Ortiz, D. Jacquemin, and S. Monstrey, Acta Chir. Belg., 108, 645 (2008).

    Article  CAS  PubMed  Google Scholar 

  28. (28)

    J. M. Pachence, J. Biomedical Mater. Res., 33, 35 (1996).

    Article  CAS  Google Scholar 

  29. (29)

    H. De Vries, E. Middelkoop, M. van Heemstra-Hoen, C. Wildevuur, and W. Westerhof, Lab. Invest., 73, 532 (1995).

    PubMed  Google Scholar 

  30. (30)

    H. J. De Vries, E. Middelkoop, J. R. Mekkes, R. P. Dutrieux, C. H. Wildevuur, and W. Westerhof, Wound Repair Regen., 2, 37 (1994).

    Article  PubMed  Google Scholar 

  31. (31)

    J. Schulz III, R. Tompkins, and J. Burke, Annu. Rev. Med., 51, 231 (2000).

    Article  CAS  PubMed  Google Scholar 

  32. (32)

    S. Suzuki, K. Kawai, F. Ashoori, N. Morimoto, Y. Nishimura, and Y. Ikada, Br. J. Plast. Surg., 53, 659 (2000).

    Article  CAS  PubMed  Google Scholar 

  33. (33)

    D. Wainwright, M. Madden, A. Luterman, J. Hunt, W. Monafo, D. Heimbach, R. Kagan, K. Sittig, A. Dimick, and D. Herndon, J. Burn Care Res., 17, 124 (1996).

    Article  CAS  Google Scholar 

  34. (34)

    S. A. Livesey, D. N. Herndon, M. A. Hollyoak, Y. H. Atkinson, and A. Nag, Transplantation, 60, 1 (1995).

    Article  CAS  PubMed  Google Scholar 

  35. (35)

    R. S. Kirsner, V. Falanga, and W. H. Eaglstein, Trends Biotechnol., 16, 246 (1998).

    Article  CAS  PubMed  Google Scholar 

  36. (36)

    H. O. Rennekampff, J. F. Hansbrough, V. Woods Jr, and V. Kiessig, J. Burn Care Res., 17, 213 (1996).

    Article  CAS  Google Scholar 

  37. (37)

    I. Jones, L. Currie, and R. Martin, Br. J. Plast. Surg., 55, 185 (2002).

    Article  CAS  PubMed  Google Scholar 

  38. (38)

    Y. M. Kim, H. T. Yang, H. J. Lim, D. Kim, J. Hur, J. H. Kim, Y. S. Cho, and W. Chun, J. Korean Burn Soc., 15, 121 (2012).

    Google Scholar 

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Correspondence to Wook Chun.

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Acknowledgments: This study was supported by a grant from the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI15C1486). This research was supported by the National Research Foundation of Korea (NRF) and funded by the Ministry of Education (NRF-2017R1A2B4002536). This research was also supported by the Hallym University Research Fund (HURF-2014-15).

Dogeon Yoon is earlier known as Hyeon Yoon.

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Yoon, D., Lee, JS., Joo, S.Y. et al. Clinical Outcome of Cryopreserved Acellular Dermal Matrix for Full-Thickness Burns. Macromol. Res. 26, 780–787 (2018). https://doi.org/10.1007/s13233-018-6109-x

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Keywords

  • cryopreserved acellular dermal matrix
  • freeze-dried acellular dermal matrix
  • split-thickness skin graft
  • full-thick excision
  • burn