The search for an ideal temporary skin substitute: AWBAT

Abstract

Objective: The search for an ideal temporary skin substitute is a continuous quest. Without the ability to provide active transport systems powered by adenosine triphosphate or adenosine diphosphate that pump fluid out on demand, all skin substitutes, however effective, would be a compromise. Therefore, the best that any current wound covering design can do is to strive to produce all the other qualities of an ideal skin substitute. Recently developed technology utilized in AW BAT attempts to better maximize those attributes.

Methods: Desirable traits of an ideal skin substitute include adherence, moisture permeability control, infection control, safety, pain management, physical adaptability, transparency, stability, cost-effectiveness, and ease of application and removal. Analysis of the optimization of these traits exemplifies the proficiency of a skin substitute.

Results: Improvements in porosity and manufacturing methodology intend to increase AWBAT's capability over existing products to better fulfill the ideal properties of a skin substitute.

Conclusion: It is expected that new technological improvements in AWBAT will provide improved performance over existing skin substitutes. Increased porosity and continuity of the 3-dimensional silicone-nylon membrane are expected to improve acute adherence and reduce the potential for infection associated with fluid accumulation, and the elimination of cross-linking agents in the collagen application is expected to improve the interaction with fibrin and eliminate the potential for allergic reaction to those agents.

Figure 1

Biobrane and AWBAT comparative structure and design: an illustration of the difference in the structure of Biobrane, AWBAT-S and AWBAT-M with respect to pore density, pore configuration, and nylon structure integrity. The left scanning electron microscope (SEM) image depicts a hole of Biobrane and the destruction of the 3-dimensional nylon structure. The center image depicts a pore of AWBAT-S, which, designed as a superficial burn cover, is 500% the porosity of Biobrane. The right image depicts a pore of AWBAT-M, which, designed as a meshed autograft cover, is 1000% the porosity of Biobrane. Both AWBAT photographs show the 3-dimensional structure of the nylon remaining intact and undamaged.

Figure 2

AWBAT-Plus.