Acellular porcine skin and allogeneic skin as wound-covering materials for extensive deep burns:a comparative study

Abstract

Objective To evaluate the advantages of microskin graft using acellular porcine skin for treatment of extensive deep burns by comparing with that using allogeneic skin.Methods A retrospective analysis was conducted on 70 severe burn patients who were treated in the Second Affiliated Hospital of Kunming Medical University during Jan.1999 to Jan.2011.The patients were divided into the acellular porcine skin group and allogeneic skin group,each containing 35 patients.The survival rates of microskin grafts were determined at 4 weeks post-operation.Besides,the rejection of acellular porcine skin and allogeneic skin,changes of body temperature,white blood cell(WBC) count,lymphocyte and serum protein were observed at pre-and post-operation.Results(1) The survival rate was(71.5±6.6)% in acellular porcine skin group and(70.6±7.5)% in allogeneic skin group,with no significant difference found between the two groups(P0.05).(2) Acellular porcine skin group.At 3 days post-operation the acellular porcine skin was still attached to the wound,most of the skin was not discolorated,and small part of the skin became cinnamomeous.The acellular porcine skin was gradually separated from the auto-microskin at 3-4 weeks post operation,and there was small amount of exudates under the acellular porcine skin,which could be drained through a small cut.In the pressed area,there was still a small amount of exudates,but the acellular porcine skin was not dissolved and the microskin grafts survived and became confluent.(3) Allogeneic skin group.The allogeneic epidermal was rejected and was off from the wound at 3-14 days post transplantation,and at 10-30 days after transplantation the allogenic dermis became dry.During 25-60 days after transplantation,the allogenic dermis was completely stripped off,the microskin grafts became confluent,and the wound was healed.(4) The body temperature of the two groups was significantly descended after operation(P0.01).The temperature of acellular porcine skin group was significantly lower than that of allogeneic skin group at 14 day post-operation(P0.01).(5) The WBC count and percentage of neutrophils were also significantly decreased in both two groups after operation(P0.05),and WBC counts in the acellular porcine skin group was significantly lower than those in the allogeneic skin group at 7 and 14 days after operation(P0.05,P0.01).The peripheral blood lymphocytes were also significantly increased after operation(P0.01) and the lymphocytes in the acellular porcine skin group were significantly less than those in the allogeneic skin group at 14 days after operation(P0.01).Blood biochemistry results showed no significant differences in the protein levels between the two groups(P0.05).Conclusion Microskin graft using acellular porcine skin,instead of allogeneic skin,for extensive burn patients can inhibit systematic inflammatory response,improve the nutrition condition,and reduce the using of allogeneic skin.Acellular porcine skin might be a suitable alternative for allogeneic skin.