Wound contraction, skin graft

Mean wound area assessment of the treatment groups showed that immediate skin graft alone contracted less (7.12% surface area contraction) than both the immediate and the delayed graft over polymer treatment groups (21.63% and 37.57%, respectively). Examination of the curve over time suggests that for the delayed group, wound contraction appreciably stopped on application of the skin graft. 

When collagen-GAG matrices which can significantly delay the onset of wound contraction are seeded with a minimum density of easily separable skin cells (basal cells) from the same animal, and the cell-seeded matrices are then grafted, wound healing is affected in an even more profound way In this case,... 

S.T. Boyce, M.C. Glafkides, T.J. Foreman, J.F. Hansbrough, Reduced wound contraction after grafting of full-thickness burns with a collagen and chondroitin-6-sulfate (GAG) dermal skin substitute and coverage with biobrane, J. Burn Care Res. 9 (4) (1988) 364-370. 

To address this issue of wound contraction, a 30-nm-thick biodegradable, nucroporous polyurethane membrane was bonded to the superficial surface of a new 2 mm-thick foam matrix. This was intended to seal the foam, acting as a barrier to the development of linear collagen fibers on the surface before application of the skin graft, which... 

Historically, using cultured or sprayed-on epithelial autograft to create stable robust epithelium on large wounds has been expensive and unpredictable in its outcome. The lack of dermal support results in friable, unstable cover that shears readily and allows wound contraction. By culturing autologous skin in vitro, the CCS can reduce the morbidity of extensive skin graft harvest and create a stable wound reconstruction with minimal contraction in extensive wounds. The work described above demonstrates proof of concept that CCS can be cultured in vitro and can be applied to integrated, delaminated BTM, and can take and/or deliver cells to the wound to result... 

Boyce, S.T., Supp, A.P., Swope, V.B., and Warden, G.D., Vitamin C regulates keratinocyte viabihty, epidermal barrier, and basement membrane formation in vitro, and reduces wound contraction after grafting of cultured skin substitutes, /. Invest. Dermatol., 118,565,2002. 

Figure 1. Kinetics of skin wound contraction in the presence of polymeric grafts which undergo enzymatic degradation at two different rates, R = 17 enzyme units (e.u.) and R = 231 e.u. The variation in R was achieved by controlling the duration of cross-linking of the collagen-graft-glycosaminoglycan in aqueous glutaraldehyde.

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