Utilisation des matrices dermiques dans le traitement primaire des brûlures dans un centre de traitement des brûlés de province au royaume uni

2020 
The gold standard of treatment for major burns is early burn excision and autografting. In major burns this is complicated by a lack of donor site availability. Another challenge after burn injury is achieving optimal cosmetic and functional outcomes. Dermal regeneration templates (DRT) are biomatrices that help to address these problems. Within our centre the most commonly used are two-stage Integra® and single-stage Matriderm®. We review the use and outcomes of DRT in primary burns reconstruction within our regional burns centre. All patients undergoing primary burn reconstruction using Integra® (n=59) or Matriderm® (n=35) over a 13-year period were included. Integra® was used in patients with significantly larger burns (20.4% TBSA vs 1.7% TBSA). Comparable levels of graft take were seen in both groups. Major infections were significantly higher in the Integra® group (11/35 compared to 3/59). There was no significant difference in haematoma development, hypertrophic scarring or the need for secondary reconstructive surgery. Burn contractures developed in 15 patients treated with Matriderm® and 21 with Integra®. DRT have been used safely and effectively and have played an increasingly important role in our service over the last 13 years. Integra® is used primarily in large burns with limited donor sites and Matriderm® in smaller burns in cosmetically sensitive areas.
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