Background: Skin substitutes were developed as an alternative
to skin grafts, especially for burn patients. Autologous
skin grafting is a painful procedure, and often the extent of
damaged skin is too large to be covered by autologous tissue
graft in existence of limited donor skin. Our aim of the study
was to evaluate the use of dermal substitutes in the treatment
of acute and chronic wounds of the hand and to establish an
applicable protocol of definitive wound management.
Methods: The study included 85 adult patients having
acute and chronic wounds of the hand. They were divided
into 2 groups Group (A): Fifty-five Patients treated with
Single-layer dermal substitutes and STSG applied to the
wound bed in a one-stage procedure, group (B): Thirty Patients
treated with skin grafting alone. Scar Evaluation was done
by Pre-& post-operative photography. The Vancouver Scar
Scale, Histopathological examination at 45 days postoperatively,
Range of motion and Patient satisfaction.
Results: Statistical analysis showed significant differences
between the two groups.
Conclusion: A true “skin substitute" would act like an
autologous skin graft in adhering to the wound bed while
providing the physiological and mechanical functions of
normal skin. The use of dermal substitutes represents a promising
treatment for acute burns and chronic wounds.