Prospective study on burns treated with Integra®, a cellulose sponge and split thickness skin graft Comparative clinical and histological study-Randomized controlled trial

Background: The aim of this study was to compare three different methods to cover excised bum wounds in a randomized controlled trial. Methods: Fascially excised burn wounds, measuring 10 cm x 5 cm, were covered with Integra (R), split thickness skin graft (STSG), and a viscose cellulose sponge Cellonex (TM) in each of ten adult patients. Integra (R) and Cellonex (TM) treated areas were covered with thin STSG on day 14. Biopsies were taken 3, 7, 14, and 21 days, 3 months, and 12 months after surgery, and samples were subjected to a range of immunohistochemical stains, in addition to hematoxylin and eosin (HE). Scar assessment was performed 3 and 12 months post-operatively with the Vancouver Scar Scale (VSS). Results: Inflammation was not substantial in any of the study areas, but Cellonex (TM) had the most neutrophils, histiocytes, and lymphocytes with significant differences on days 7 and 14. Complete vascularization of Integra (R) seemed to occur later compared to the other materials. STSG had the most myofibroblasts on day 14 (p = 0.012). In VSS the quality of the scar improved in all materials from 3 to 12 months. Conclusions: The final results for all treatments after 12 months demonstrate equal clinical appearance, as well as histological and immunohistochemical findings. (C) 2013 Elsevier Ltd and ISBI. All rights reserved.