[Development of non-cellular dermis: a step towards a total artificial skin]

In large cutaneous defects due to severe burns, dermal mesenchyme healing has to be controlled in order to avoid granulation tissue that rapidly leads to important contractures and hypertrophic scars. We report a study about the use of an artificial dermis made of human collagen (I and III) and several glycosaminoglycans. This artificial dermis was grafted on Sprague-Dawley rats after a 9 cm2 skin excision on the back. An identical control area was made just under it, on the same animal. The animals were killed on day 2, 7, 14, 21, 30 and different parameters were studied: clinical study, bacteriological study, histopathological appearance, scanning and transmission electron microscopy, immunological study, physical parameters, UV absorption. Direct and indirect cytotoxicity tests, performed on cell cultures showed no change in the morphology and of the growth of the keratinocytes or of the fibroblasts. A biocompatibility study showed on the early days (day 2, 7, 14) that adherence of artificial dermis to the underlying tissue was good. There was virtually no bacterial colonization. Ultrastructural study showed an important cellular colonization, with an inflammatory appearance at the beginning. After a while, fibroblasts appeared, with synthesis of neocollagen fibers as early as the second week. Histological study showed neovessels in the artificial dermis. Later (day 21, 30) the inflammation was less severe and the amount of endogenous collagen increased.(ABSTRACT TRUNCATED AT 250 WORDS)