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Updated: Jul 16, 2025
A Murine Model of a Burn Wound Reconstructed with an Allogeneic Skin Graft
Published on: August 8, 2020
Short- and Long-term Outcomes of an Acellular Dermal Substitute versus Standard of Care in Burns and Reconstructions:
Kim L M Gardien1, Anouk Pijpe, Katrien M Brouwer
1Kim L. M. Gardien, MD, is Burn Physician and Anouk Pijpe, PhD, is Epidemiologist and Research Coordinator, Association of Dutch Burn Centres, Beverwijk, the Netherlands; Burn Center, Red Cross Hospital, Beverwijk; Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam; and Amsterdam Movement Sciences (AMS) Institute, Amsterdam UMC. Katrien M. Brouwer, PhD, is Senior Researcher, Association of Dutch Burn Centres. Matthea Stoop, RN, is Research Nurse, Association of Dutch Burn Centres; Burn Center, Red Cross Hospital, Beverwijk; Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam. Simarjeet K. Singh is Research Student, Burn Center, Red Cross Hospital, Beverwijk. Floyd W. Timmermans, MD, PhD, is Clinical Researcher, Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam; and AMS Institute, Amsterdam UMC. Marcel Vlig, BAS, is Senior Technician, Association of Dutch Burn Centres. Paul P. M. van Zuijlen, MD, PhD, is Plastic Surgeon and Professor of Burn Care, Burn Center, Red Cross Hospital, Beverwijk; Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam; AMS Institute, Amsterdam UMC; and Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk. Esther Middelkoop, PhD, is Director of Research and Professor of Wound Healing and Skin Regeneration, Association of Dutch Burn Centres, Beverwijk, the Netherlands; Burn Center, Red Cross Hospital, Beverwijk; Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam; and AMS Institute, Amsterdam UMC.
Objective:
Dermal substitutes promote dermal regeneration and improve scar quality, but knowledge gaps remain regarding their efficacy and indications for use. The authors investigated the safety and short- and long-term efficacy of an acellular dermal substitute in patients with full-thickness wounds.
Methods:
This intrapatient randomized controlled, open-label, phase I (safety) and phase II (efficacy) study compared treatment with Novomaix (Matricel GmbH), a dermal collagen/elastin-based scaffold, with split-thickness skin graft (STSG) only. The primary safety outcome was graft take at 5 to 7 days postsurgery. Postsurgical scar quality was assessed by measuring elasticity, color, and scores on the Patient and Observer Scar Assessment Scale at 3 months, 12 months, and 6 years.
Results:
Twenty-five patients were included, of which 24 received treatment allocation. Graft take and wound healing were statistically significantly lower/delayed in the dermal matrix group compared with STSG alone (P < .004). Serious adverse events were delayed epithelialization in four dermal matrix and three STSG study areas. At 12 months postsurgery, skin extension (P = .034) and elasticity (P = .036) were better for the dermal matrix group compared with the group receiving STSG alone. Other scar quality parameters at 12 months and 6 years did not differ between treatment arms.
Conclusions:
The dermal substitute was a safe treatment modality for full-thickness wounds. Compared with STSG alone, time to wound healing was slightly increased. Nevertheless, scar quality at 12 months seemed somewhat improved in the wounds treated with the dermal substitute, indicative of enhanced scar maturation. In the long term, final scar quality was similar for both treatment modalities.
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