REDUCED WOUND CONTRACTION AND SCAR FORMATION IN PUNCH BIOPSY WOUNDS -NATIVE COLLAGEN DERMAL SUBSTITUTES - A CLINICAL-STUDY

In full-thickness skin wounds dermal regeneration usually fails, resul ting in scar formation and wound contraction. We studied dermal regene ration by implantation of collagenous matrices in a human punch biopsy wound model. Matrices were made of native bovine collagen I fibres, a nd either hyaluronic acid, fibronectin, or elastin was added. Matrices were placed in 6-mm punch biopsy holes in seven patients (biopsies we re used for the grafting of leg ulcers), and covered with a protective semi-permeable polyether urethane membrane. Histology, wound contract ion and dermal architecture were studied. Dermal architecture was eval uated using a recently developed laser scatter technique. All collagen matrices showed a tendency to reduce wound contraction, compared with control wounds; elastin- and fibronectin-treated matrices showed sign ificantly less contraction than control wounds. Only the addition of e lastin had a clear beneficial effect on dermal architecture; collagen bundles were more randomly organized, compared with control wounds, an d wounds treated with collagen matrices coated with fibronectin or hya luronic acid, or without coating. We conclude that the punch biopsy wo und model provides important information on dermal regeneration in hum ans, Native collagen matrices with elastin contributed to dermal regen eration and reduced wound contraction, in contrast with matrices coate d with fibronectin or hyaluronic acid, or without coating. Future clin ical studies of large-area, full-thickness wounds will be required to establish their clinical relevance for leg ulcer and burn treatment.