Matriderm and Split-Thickness Skin Graft for Burn Contractures of the Hands

Abstract

Scar contracture and hypertrophic scar of the hands are common late complications encountered in burn patients which result in imperfect wound healing. Burns often cause full-thickness skin defects which should be ideally reconstructed with full-thickness skin grafts or flaps. In burn victims with large TBSA these options are limited due to the lack of sufficient donor site. Nonetheless, the dermis can be partially reconstructed using split-thickness grafts which have become the mainstay of treatment in extensive burns. Although the split-thickness skin grafts are versatile, their use on the face or on the hands has undesirable outcomes such as poor color match, poor skin elasticity, graft contracture with limitation of joint movement and hypertrophic scars, due to a discontinuous healthy dermal layer. To compensate for this, numerous artificial dermal substitutes have been developed such as Matriderm.