Histologic Changes of Various Artificial Dermis Graft in Rabbit

Lee, Dong Hun; Han, Dong Wan; Baik, Bong Soo

Abstract

A full-thickness skin defect was made on the back of rabbits to evaluate the characteristics of commonly used artificial dermis. The artificial dermis used in this experiment was Alloderm , Integra and Terudermis . The Integra and Terudermis are bilayer membranes composed of bovine collagen matrix and silastic membrane which functions as the epidermis. Alloderm is acellular dermal matrix obtained from human cadaveric skin. These artificial dermis were applied to the full-thickness skin defect on the back of rabbits and the histologic changes were evaluated 3 days, 1 week, 10 days, 2 weeks and 4 weeks after its application. Thin split-thickness skin graft taken from the abdomen was applied on the artificial dermis immediate after Alloderm graft and 2 weeks after Terudermis and Integra graft. The process of skin graft "take" was evaluated on the 3 rd, 5 th, and 7 th day after split-thickness skin graft. The formation of new collagen and capillaries, and infiltration of fibroblasts were found earliest and most remarkably in case of Alloderm , latest and least remarkably in case pf Integra . The arrangement of collagen fibers was most regular in Alloderm but there was no significant difference between Terudermis and Integra . The original structure of the artificial dermis disappeared 1 week after Terudermis graft but the structure remained until 4 th week after Integra graft, which means the cross-link of Integra is stronger than the other artificial dermis. The thickness of artificial dermis decreased from initial 0.43 mm to 0.34 mm(79.7% of initial thickness) on the 4 th week in Alloderm , from 1.22 mm to 0.89 mm(73.0%) in Terudermis , from 1.34 mm to 1.13 mm(84.3%) in Integra . The decrease of thickness was statistically significant in all artificial dermis. In conclusion, Alloderm has best cellular affinity to the host: the skin graft over the Alloderm turns out to be the best, but Alloderm is the thinnest among artificial dermis. Terudermis has better cellular affinity to the host than Integra , which means better vascularity and more collagen fibers in Terudermis . However, Intra keeps thicker volume than Terudermis . Best artificial dermis will be chosen according to the clinical conditions.