dressings

Scars and Wound Healing


Wound Healing


Biologic dressings


Junkins-Hopkins JM (Johns Hopkins Med Insts, Baltimore, MD) J Am Acad Dermatol 64:e5-e7, 2011§



R.E. Salisbury, MD



Evidence Ranking


• E



Expert Rating


• 1



Abstract



Background


Various human and skin substitutes are available for use as biologic dressings. The choice of product relies on multiple factors, such as type, size, and depth of the wound; comorbid conditions; and patient preferences. The advantages and disadvantages of various biologic dressings were outlined.



Products


Epicel is an epidermal autograft cultured from healthy human skin and has a 1-day half-life. It is most useful as a lifesaving intervention in burn patients, but also successful for pyoderma gangrenosum and epidermolysis bullosa.


Dermal and composite biologic dressings include Apligraf, which contains living allogeneic cells. The epidermal component is neonatal foreskin keratinocytes seeded on a dermal component of neonatal foreskin fibroblasts in a matrix of bovine type I collagen. When stored at 68° to 73° F, a 0.75-cm disk has a 10-day shelf life. This temporary wound cover is secured to the sterile, debrided, and edema-free wound bed using sutures or dressing and changed weekly. Apligraf’s performance is significantly better than compression in healing large, deep venous ulcers present for more than a year. Osteomyelitis and amputation rates are lower with Apligraf, and scars may be more pliable and less vascular than healing with secondary intention.

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May 5, 2016 | Posted by in Aesthetic plastic surgery | Comments Off on dressings

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