Article
Acellular porcine dermis (Xe-Derma®) for burns treatment
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Authors
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P. Brychta
- Masaryk University, Department of Burns and Reconstructive Surgery, Medical Faculty, Brno, Tschechische Republik
| Published: | February 19, 2013 |
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Outline
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Introduction: Acellular matrix products differ mainly in the source of tissue materials and methods used during manufacture. A variety of animal and human derived products are available. Acellular matrices have been used mainly in burns. There is also an increasing range of acellular products for use as treatment of chronic wounds and surgical implants in abdominal, plastic and reconstructive surgery. Understanding the clinical advantages and limitations of individual products is crucial to effective use and patient outcomes.
Methodology: One of the available product is Xe-Derma that was developed and is produced in Czech Republic. Xe-Derma is a dry, sterile, acellular porcine dermis. Its original 3D matrix of collagen and elastic fibres promotes cell migration into the wound, their proliferation, differentiation and forming of multi-layered, stratified neo-epidermis. Hydrated Xe-Derma displays biomechanical properties similar to those of human skin. Xe-Derma spontaneously adheres to the wound and immediately prevents bleeding. After the wound becomes epithelialized, the dry Xe-Derma peels off, usually within 4–10 days.
Results: Xe-Derma is indicated for IIa / IIb burns treatment, but positive clinical experiences in full thickness burns treatment have been also published as well as study evaluating Xe-Derma as a temporary cover of widely meshed autografts. Xe-Derma can also be meshed or serve as a matrix for keratinocytes or other cultured cells. In our burn centre we evaluated Xe-Derma in treatment of superficial, split-thickness and full-thickness burns. Three main clinical outcomes were evaluated: time to re-epithelisation, reduction of pain and the costs of the treatment. 13 patients were included to the evaluation. The time to re-epithelisation was 10.5 days using Xe-Derma. The pain was evaluated on the 10-scale by patients and was scored 1.9 in average. Finally, the cost of the treatment using Xe-Derma was cheaper as the standard treatment using silver sulfadiazine (Flammazine).
Conclusion: Xe-Derma as a natural matrix supports formation of multi-layered stratified neo-epidermis and shortens time to healing. Patients may benefit from one-time application that brings rapid reduction in pain, minimises wound infection risk and reduces anaesthetic consumption. Number of re-bandages is minimised as well as time of health care professionals and so are all the financial costs of the treatment.
