Burns, trauma, chronic and complex wounds can result in complete loss of skin, leading to infection, increased insensible water loss, hypothermia, difficulties in patient management. Autografts have been used as a treatment, but limitations, such as scarcity of donor areas or situations where the recipient is not in favour of coverage with grafts, can occur.
In 1981, Burke and Yannas leveraged a new line of research in skin substitutes. Researchers have aimed to develop a material that has ideal physical chemical properties and also promotes the migration of fibroblasts and blood vessels. Skin substitutes and dermal matrices consist of a heterogeneous group of biological and/or synthetic elements that support the temporary or permanent occlusion of injuries.
Tissue engineering is presented as a promising field that can synthesize and manufacture a polymer similar to that of the target tissue intended to mimic characteristics
There are several criteria for the development of the ideal scaffold: (1) the surface should allow cell adhesion, promote cell growth, and enable the functions of differentiated cells; (2) the material should be biocompatible (3) the material should be biodegradable; (4) the porosity must be sufficiently large for cell adhesion and migration, regeneration of the extracellular matrix (5) the material must be in a processable and reproducible form in three-dimensional structure, and mechanically strong in order to promote stability to the injured/defective tissue.
Lenon Cardoso and Coll performed this study to assess the efficiency of a porous bioresorbable membrane Poly (L-co-DL lactic acid)-co-trimethylene carbonate, PL-co-DLA-co-TMC, as a dermal substitute associated with partial skin graft in rats.
The poly (L-co-DL lactic acid-co-trimethylene carbonate), denoted PL-co-DLA-co-TMC (50:50), was synthesized in the Laboratory
A 1.5×1.5 cm defect was created on the backs of 40 Wistar rats. The rats were divided into control groups.
The analysis of type I and type III collagen fibres was performed from the observation of three random samples of the histological slides in the dermis region only.
these results suggest that the regeneration of the polymer allowed for good dermis formation with less shrinkage, unlike what occurs in a scar by secondary intention. The polymer also provided the greater thickness of the dermis in the control group, which was confirmed by histomorphometry.
The results showed that polymer was biocompatible and allowed better regeneration of the dermis with less shrinkage, unlike what occurs in second intention healing. The study material was shown to act as a biocompatible dermal substitute and promoted less scarring of the dermis.
Authors: Lenon Cardoso, Marília Colturato Cleto, Maria Lourdes Peris Barbo, Andréa Rodrigues Esposito, Flavio Stillitano Orgaes, and Eliana Aparecida de Rezende Duek
Newspaper: Int J Burns Trauma. 2017; 7(4): 34–46.