Gelatin-Collagen Nonwoven Scaffold Provides an Alternative to Suprathel for Treatment of Superficial Skin Defects.

OBJECTIVE: To evaluate the effect of a new biologic gelatin-collagen nonwoven scaffold compared with a more common synthetic wound dressing on the healing of superficial wounds. METHODS: Three superficial wounds with a depth of 0.5 mm and a length of 2.4 cm were created on the flanks of six minipigs using a skin dermatome. One wound on each pig was treated with the new nonwoven scaffold, one with the more common synthetic wound dressing, and one functioned as an untreated control wound. All three wounds were then covered with a semipermeable, sterile, transparent film. RESULTS: After 7 days, complete wound closure of all wounds could be detected; epidermal thickness and the number of epidermal cells of all treated wounds were significantly increased compared with the control wounds. The nonwoven dressing showed slightly better results compared with the more common dressing. CONCLUSIONS: The nonwoven scaffold is an interesting and competitive material for promoting epidermal wound healing. Because it is a biologic dressing, it degenerates completely and does not have to be removed from the wound. Further research should be conducted to compare this new dressing with other currently available wound treatments.

Evaluation of scar quality after treatment of superficial burns of the hands and face with Dressilk or Biobrane-An intra-individual comparison.

INTRODUCTION: The aesthetic outcome after burn of exposed areas such as the hand and face is of high importance. A number of wound dressings used for the treatment of superficial and partial thickness burns promise rapid wound healing and reduced scarring. Previously, wound healing of hands and faces with superficial burns treated with Dressilk® compared to Biobrane® was evaluated intra-individually with similar results. Nevertheless, up to date objective information regarding the scarring after superficial burns treated with Dressilk® does not exist. METHODS: Therefore, 30 patients with superficial burns of the hand and face that were treated with Dressilk® and Biobrane® simultaneously were included in the study. An objective scar evaluation was performed analyzing melanin and erythema levels, skin elasticity, trans-epidermal water loss and scar perfusion three and six and 12 months after injury. Furthermore, a subjective scar evaluation was performed with the patient and observer scar assessment scale (POSAS) and the Vancouver scar scale (VSS). RESULTS: Dressilk® and Biobrane® both lead to an aesthetic pleasing outcome after superficial burns of the hands and faces. Regarding the objective scar evaluation only trans-epidermal water loss of burned hands after 6 months showed significant differences between the two dressings. However, these differences were not detected in the 12-month follow up examination. In the subjective scar evaluation no statistical differences could be found between the dressings. All patients stated high satisfaction of scar quality. CONCLUSION: Dressilk® is an interesting alternative to Biobrane® for the treatment of superficial burns of aesthetic and functional important areas.

A prospective intra-individual evaluation of silk compared to Biobrane for the treatment of superficial burns of the hand and face.

INTRODUCTION: An ever-increasing number of commercially available dressings have been applied to treat superficial burns with the aim to reduce pain and inflammation and lead to a fast wound healing and scar reduction. Nevertheless the search for cheap and effective wound dressing proceeds. Dressilk® consisting of silkworm silk showed good results for wound healing in regards to scarring, biocompatibility and reduction of inflammation and pain. Therefore it seemed to be an interesting product for the treatment of superficial burns. METHODS: In a prospective intra-individual study the healing of superficial burns was evaluated after the treatment with Dressilk® and Biobrane® in 30 patients with burns of the hand and face. During wound healing pain, active bleeding, exudation, dressing change and inflammation were evaluated using the Verbal Rating Scale 1-10. Three months later scar appearance was assessed by VSS (Vancouver Scar Scale) and POSAS (Patient and Observer Scar Scale). RESULTS: With regard to re-epithelialization, pain, inflammation and acute bleeding both dressings were equivalent. High subjective satisfaction rates were reported for both Dressilk® and Biobrane® dressings in regard to comfort and mobility of the face. Biobrane®, applied as a glove was subjectively preferred for burns of the hand. Regarding their cost efficiency Dressilk® was clearly superior to Biobrane®. Long-term results were similar. CONCLUSION: The "ideal" wound dressing maximizes patients' comfort while reducing pain and promoting wound healing. Dressilk® and Biobrane® both provided an effective and safe healing environment, showing low overall complication rates with respect to infection and exudation on superficial burns of the hand and face. Therefore Dressilk®, being clearly superior to Biobrane® in cost efficiency is an interesting alternative especially for the treatment of superficial burns of faces.

A Novel Collagen-Gelatin Scaffold for the Treatment of Deep Dermal Wounds-An Evaluation in a Minipig Model.

BACKGROUND: Today, autologous skin transplantation is frequently used for full-thickness skin defects. There is still a high demand for new wound-healing products to replace autologous skin transplantation. OBJECTIVE: In this context, the effect of a new collagen-gelatin scaffold on full-thickness skin defects was evaluated. MATERIALS AND METHODS: Four full-thickness skin defects were created surgically on the dorsum of 6 Göttingen minipigs. Three wounds were randomly treated with a novel collagen-gelatin scaffold in different thicknesses, whereas the fourth wound was left untreated and served as a control wound. During the experimental period of 21 days, a close-up photographic documentation was performed. Afterwards, the areas of the initial wounds were excised and examined histologically. RESULTS: The systematic evaluation of 24 wounds showed that treatment with the new collagen-gelatin scaffold led to an accelerated wound repair of 1.1 days. Compared to control wounds, it also demonstrated improved skin quality in regard to epidermal thickness. CONCLUSION: The new collagen-gelatin scaffold supports and accelerates dermal wound repair compared to untreated control wounds. Nevertheless, wound treatment with the scaffold was only performed on the first day. In further studies, the impact of multiple scaffold applications on full-thickness skin defects should be investigated.

Frequent Application of the New Gelatin-Collagen Nonwoven Accelerates Wound Healing.

OBJECTIVE: Mortality after chronic wounds is high. Thus, proper and effective therapy is of critical importance. Adult mammalian skin cannot regenerate spontaneously. It heals under scar formation in a process of repair. In general, wound closure is achieved through a combination of contraction, scar formation, and regeneration. To enhance wound healing, research groups are continuously inventing and evaluating novel skin replacement products. A single application of a new gelatin-collagen nonwoven accelerates wound closure of full-thickness skin defects. Therefore, the authors' objective was to evaluate the effect of a higher application frequency of the nonwoven on wound closure in a minipig model. MATERIALS AND METHODS: Four full-thickness skin defects were created surgically on the dorsum of 12 Göttingen minipigs. Next, 3 wounds were treated randomly with a novel gelatin-collagen nonwoven in different thicknesses, while the fourth wound was left untreated and served as the control wound. Moreover, 6 minipigs achieved multiple applications of the wound dressing. During the experimental period of 21 days, a close-up photographic documentation was performed. Finally, the areas of the initial wounds were excised and examined histologically. RESULTS: More frequent application of the nonwoven achieved accelerated wound healing and better epidermis quality compared with a single application. Mean time until wound closure of all wounds treated with a multiple application of the nonwoven was 11.0 (± 1.2) days, compared with a single application of the nonwoven with 12.4 (± 1.26) days and control wounds with 13.5 (± 1.19) days. Furthermore, the epidermal thickness of all wounds treated with multiple applications of the nonwoven was increased by 10.67 µm (31.89 ± 8.86 µm, P = .0007) compared with a single application of the nonwoven and by 6.53 µm (27.75 ± 7.24 µm, P = .0435) compared with the control group. CONCLUSIONS: Multiple applications of the gelatin-collagen nonwoven may be an appropriate treatment for chronic wounds leading to a fast wound closure through a combination of contraction and re-epithelialization.

Comparison of short- with long-term regeneration results after digital nerve reconstruction with muscle-in-vein conduits.

Muscle-in-vein conduits are used alternatively to nerve grafts for bridging nerve defects. The purpose of this study was to examine short- and long-term regeneration results after digital nerve reconstruction with muscle-in-vein conduits. Static and moving two-point discriminations and Semmes-Weinstein Monofilaments were used to evaluate sensory recovery 6-12 months and 14-35 months after repair of digital nerves with muscle-in-vein in 7 cases. Both follow-ups were performed after clinical signs of progressing regeneration disappeared. In 4 of 7 cases, a further recovery of both two-point discriminations and in another case of only the static two-point discrimination of 1-3 mm could be found between the short-term and long-term follow-up examination. Moreover, a late recovery of both two-point discriminations was demonstrated in another case. Four of 7 cases showed a sensory improvement by one Semmes-Weinstein Monofilaments. This pilot study suggests that sensory recovery still takes place even when clinical signs of progressing regeneration disappear.