dried for longer shelf life used for temporary covering of clean wounds such as

Dried for longer shelf life used for temporary

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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
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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
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