INTEGRA® Dermal Replacement Template Case Study

In earlier days, a burn victim was treated with skin graft from unharmed part of the body, which if not available, a section of skin was obtained from a donor preferably a cadaver. This was basically done because unlike most wounds, skin damaged from thermal injuries can never repair themselves and to make the matter worse, a person can die from the accident due to loss of plasma and from infection. The latter source of allograft often led to rejection by the recipient’s immune system. So, in case of extensive burns, a surgeon’s first and last resort was to cover the burn areas with bandages as primary treatment. What it did in actuality was prolong the death of the patients rather than keeping them alive. Even if they survived, they were left
This modern wound care device consists of two layers-the upper layer mimics the epidermis and the layer underneath is a porous matrix which replaces the dermis. The top temporary epidermis is made of silicone which provide immediate physiological closure preventing fluid and heat loss along with functioning as a bacterial barrier. The underlying matrix layer consists of cross-linked tendon collagen of bovine origin and glycosaminoglycan (GAG) which provides a bioresorbable framework for capillary growth and cellular
The wound rather contracts and forms a scar. Now the regeneration template, otherwise known as the artificial skin stops contraction of the wound, provides a scaffold for regenerating dermal skin cells. Dermal rejuvenation takes place when macrophage, lymphocytes, fibroblasts infiltrate into the matrix followed by neovascularisation. The fibroblasts promote the production of endogenous collagen, which takes place of the collagen-GAG complex as it degrades slowly and simultaneously.
INTEGRA® Dermal Regeneration Template is placed on an excised wound from which all the non-viable cells have been removed to ensure maximum contact with the exposed lesion. The skin graft is typically secured in place by staples accompanied with dressing the area with elastic net. Sometimes the dressing are treated with antimicrobials to provide an extra layer of protection on top of the template.
At around 21 days, neodermis, a functional dermis layer, with adequate blood perfusion develops. At this stage a second surgical procedure is performed where the silicone layer is removed and substituted with an epidermal autograft (0.004-0.006 inches) upon which the healing process is