Introduction: Split skin graft treatment of full thickness-skin defects leads to scar formation, which is often vulnerable and instable. Aim of this study was the analysis of the quality of repair of clinically available biodegradable polymer dermal regeneration templates in experimental full thickness wounds. Material and Methods Full thickness wounds (3x3 cm) on both flanks of Gottingen mini pigs (n=4) were treated with either 1.) Split-thickness skin graft alone or in combination with 2.) PEGT/PBT scaffold 3.) Integra or 4.) EDC/NHS crosslinked-collagen scaffold. The wounds (n=12 per group) were examined weekly for graft take, contraction (planimetry), and cosmetic appearance. Histological samples taken after 1 and 6 weeks were used to assess scaffold angiogenesis and the quality of the scar, respectively. Results: In all wounds, graft take was in between 95-100%. The control wounds treated with showed little granulation tissue formation, whereas the collagen scaffolds were completely degraded and 3-4 times more granulation tissue was present after 1 week. The Integra and PEGT/PBT scaffolds showed only tissue ingrowth in the lower half of the scaffold, which resulted in partly loss of split skin integrity. Only basal cells survived, proliferated and regenerated a functional epidermis. After 6 weeks, control wounds showed a wound contraction of 26.0± 9.1%, Integra treated-wounds 33.5± 10.51%, collagen scaffold-treated wounds 38.2± 6.3%, and PEGT/PBT scaffold-treated wounds 52.5± 7.1%. The latter wounds had significantly more contracted compared to all other treatment groups. Microscopically the control and collagen scaffold-treated wounds showed an immature scar that was 3-4 times thicker in the collagen treated wounds. The Integra scaffold showed non-degraded collagen scaffold fibres with partly denovo dermal tissue formation and partly a strong inflammatory response against the scaffold fibres with many giant cells. The PEGT/PBT scaffold was almost completely degraded apart from scaffold reminant in the lower part of neodermis surrounded by many macrophages filled with phagocytized scaffold particles. In both wounds, scar formation had only started. Discussion: This study showed that by using different dermal regeneration templates the rate of scar formation and the quality of the scar is influenced by rate of scaffold angiogenesis and degradation, and degree of inflammation/foreign body response induced by the scaffolds.
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