Dermaler Ersatz in der Wundbehandlung

Zusammenfassung

Der Verlust der Dermis wie in Vollhautwunden führt zu erheblichen funktionellen und ästhetischen Komplikationen. Die Anwendung von biosynthetischem, allogenem oder kultiviertem dermalen Ersatz kann zu einer Verbesserung des Ergebnisses beitragen. Ein aus Kollagen-GAG hergestelltes Laminat (Integra) kann nach zellulärer Repopulation in einer zweiten Operation mit Spalthaut gedeckt werden. Allogene zellfreie Dermis kann dagegen simultan mit Spalthaut transplantiert werden und erbringt funktionell und ästhetisch ansprechende Ergebnisse. Der aus Fibroblasten und Polyglactinnetz gezüchtete dermale Ersatz (Dermagraft) kann ebenfalls zur simultanen Transplantation verwendet werden. Dermaler Ersatz kann die Wundheilung funktionell und ästhetisch verbessern.

Dermal Replacements in Wound Healing

In the absence of dermis, as in full-thickness wounds, decreased durability, hypertrophic scarring and wound contraction are major sequelae of the healed wound. In this review we report about dermal substitutes for clinical in vivo skin regeneration. A biosynthetic bilaminate Collagen-GAG replacement (Integra) is designed as a template for ingrowth of fibrovascular components and allows epidermal grafting as a second procedure. Simultaneous grafting of split-thickness skin grafts onto allogenic processed acellular dermis (AlloDerm) has been shown to improve function and cosmesis of the wound. A cultured dermal substitute (Dermagraft) consisting of allogenic fibroblasts and biodegradeable polymers is suitable as a dermal substitute for simultaneous grafting. Dermal replacements can improve function and outcome and reduce overall morbidity.

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