Transplantation of microskin autografts with overlaid selectively decellularized split-thickness porcine skin in the repair of deep burn wounds

Abstract

Selectively decellularized split-thickness porcine skin (SDSTPS) may be an optimal alternative for allograft. This study was designed to explore the efficacy of microskin autografts overlaid with SDSTPS in the repair of deep burn wounds and to resolve the problem of the shortage and risk of cadaver skin allografts. Full-thickness xenogenic skin was harvested from a healthy ternary pig, and SDSTPS was produced by the glutaraldehyde-trypsin-detergent method. Split-thickness autograft skin was harvested from patients and minced into microskin autografts. The microskin autografts with overlaid SDSTPS were applied to 31 patients with deep burn wounds, 4 to 6 days after injury, and comparisons with cadaver skin allograft were carried out on both sides of the torso and limbs. The cases were followed up for 18 months. The following parameters were investigated: time of rejection and exfoliation, percentage of epithelialized wound area, number of cases with wound ulcer, hypertrophic scars, pain and itching, apparent deformity, and functional impairment. The rejection and exfoliation time of the skin xenograft was 17 ± 3 days and that of the skin allograft was 14 ± 2 days (P < .05), whereas the epithelialized wound area 3 weeks postoperatively for the skin xenograft and allograft was 87 ± 21% and 83 ± 41% (P > .05), respectively. There was no significant difference in skin morphology between the two groups. The satisfactory function was observed in the follow-up visit for 18 months postoperatively. The authors' results indicate that the clinical effect of microskin autografts overlaid with SDSTPS in the repair of deep burn wounds is similar to that of microskin autograft overlaid with frozen cadaver skin, and SDSTPS could be an optimal alternative for allograft.