INTRODUCTION
burns, acute burns
SCAR
Dermal substitutes have emerged as valuable therapeutic options in the treatment of full-thickness wounds. Generally, the standard of care for these wounds consists of full-thickness skin graft (FTG) coverage where possible or split-thickness skin grafts (STSG) when needed. Dermal substitutes enable dermal replacement without requiring the harvesting of full-thickness skin. The poor scar quality and donor site morbidity seen after autologous STSGs, the limited availability of and morbidity seen in FTG, and the understanding of the importance of dermal regeneration for final outcomes have incentivized the further development of skin-replacement therapies. In practice, alternatives are needed that enable immediate wound coverage and enhance wound closure, while also reducing the need for FTG or STSG harvesting. Specific considerations validate the use of these substitutes, such as the location and depth of burns and donor site availability, with the aim of improving scar quality.Despite the availability of many different dermal substitutes, few high-quality clinical studies including long-term outcomes in burn and reconstructive patients are available.Research has already examined the efficacy of dermal substitutes in improving scar quality parameters in acute and reconstructive wounds.To overcome some of the known limitations of dermal substitutes, a novel dermal substitute (Novomaix; Matricel GmbH) was developed that consists of porcine collagen and elastin with a unidirectional pore structure. This pore structure may facilitate cellular ingrowth. In a porcine wound model, Boekema et alTherefore, the authors’ aim in the present study was to investigate the safety and short- and long-term efficacy of this dermal substitute in patients with acute burns and reconstructive wounds. This study is the first clinical application of dermal matrix in acute and reconstructive wounds and is designed as phase I and phase II trials.