Two-step grafting of the full thickness skin defects in pigs using the composite of atelocollagen and hyaluronic acid

The reconstruction of resistant and pliable skin in vivo is not possible wi thout the substitution of its dermal component. To explore the feasibility of two-step grafting of full-thickness skin defects, an animal experiment w as carried out. Twelve large white female pigs weighing 30 kg were used. Th e full-thickness wounds created were 5 x 5 cm in size. The composite of bovine atelocollagen and hyaluronic acid (HyproDerm) was i mplanted as the dermal substitute in the first step. The overgrafting of th is composite with a thin epidermal autograft followed as the second step te n days later. Planimetric, histologic and clinical evaluations (using the Vancouver Scar Score) of healed wounds were carried out. Studied wounds were compared with those left for spontaneous healing and those grafted immediately using der moepidermal graft without any dermal substitute. 1. Planimetric measurements have shown that the average area of the treated defects was 1245.2 mm(2), the average area of untreated defects was 386.2 mm(2) and the area of immediately grafted defects was 677.8 mm(2), one mont h after the injury. These differences were statistically significant (p < 0 .001). 2. Very good vascularisation and colonisation by fibroblasts with immediate production of collagen fibres, were observed microscopically. 3. The quality of reconstructed skin was superior to the untreated wound ac cording to the modified Vancouver Scar Score (4.91 points) treated wounds x 9.25 points (non-treated wounds) x 5.50 (immediately grafted wounds) after one month. The dermal substitute HyproDerm reduces the shrinkage of resurfaced wounds and improves the quality of reconstructed skin in pigs. Containing the harm less and approved materials, its convenient for clinical use.