dried) for longer shelf life; used for temporary covering of clean
wounds such as superficial partial-thickness wounds and donor sites;
pigskin does not vascularize but it does adhere to clean superficial
wounds and provides excellent pain control while underlying wound
epithelializes
Biosynthetic and Synthetic Dressings
Used d/t availability, sterility, and cost of biologic dressings; biosynthetic
and synthetic dressings created/used
Biobrane
– composed of nylon, silastic membrane combined with a
collagen derivative; semitransparent and sterile; indefinite shelf life, less
costly than homograft or pigskin
Biobrane
– protects wound from fluid loss and bacterial invasion; adheres
to the wound fibrin which binds to the nylon-collagen material; within 5
days the cells migrate into the nylon mesh; adherence to wound surface
correlated directly with low bacterial counts; wound remains stable once
biobrane adheres to it; can remain in place until spontaneous
epithelialization and wound healing occur; as biobrane gradually
separates – it is trimmed and leaves a healed wound
BCG Matrix
– temporary wound covering; dressing combines beta-glucan
(complex carb) with collagen in a meshed reinforced wound dressing;
beta-glucan stimulates macrophages which are vital in the inflammatory
process of healing; used for partial-thickness burns and donor sites;
applied immediately after cleaning and debridement; if burn wound
surface remains free of infection, then BCG Matrix can remain in place
until healing is complete
Other synthetic dressings:
o
Op-site = thin, transparent, polyurethane elastic film; used for clean
partial-thickness wounds and donor sites; occlusive and waterproof
but permeable to water vapor and air
o
Tegaderm, N-Terface, Duo-derm are other examples
Skin substitutes:
o
Surgically replace epidermis and dermis; enhance healing process of
an open wound when autologous skin is unavailable or limited for use;
often the choice when donor sites are inadequate or unavailable
o
Cultured epithelial autograft (CEA) – provides permanent coverage of
large wounds when harvesting skin for autografting is not an option;
biopsy of pt’s skin in an unburned area; keratinocytes are isolated and
17
epithelial cells are cultured in a lab; reproduces multiple plated sheets
of CEA to cover an already surgically excised wound
o
Disadvantages to CEA – thin, fragile and can shear easily; longer
hospital stays, higher hospital costs, require more surgical procedures
than those treated by traditional methods; pts require more
reconstructive procedures in the first 1-2 years after injury; very
limited and reserved for burn pts whose donor sites are limited
o
Integra Artificial Skin – newest type of dermal substitute, dermal
analogue composed of two main layers = epidermal layer consisting
of silicone (acts as bacterial barrier, prevents water loss), dermal layer
composed of animal collagen (interfaces with open wound surface
