In-Situ Forming Nutritional And Temperature Sensitive Scaffold Improves The Aesthetic Outcomes Of Meshed Split-Thickness Skin Grafts In A Porcine Model.

OBJECTIVE: Full-thickness burn wounds require immediate coverage, and the primary clinical approaches comprise of skin allografts and autografts. The use of allografts is often temporary due to the antigenicity of allografts. On the other hand, the availability of skin autografts may be limited in large burn injuries. In such cases, skin autografts can be expanded through the use of a skin mesher, creating meshed split-thickness meshed skin grafts (MSTSG). Meshed split-thickness skin grafts have revolutionized the treatment of large full-thickness burn injuries since the 1960s. However, contractures and poor aesthetic outcomes remain a problem. We previously formulated and prepared an in-situ forming skin substitute, called MeshFill (MF), which can conform to complex shapes and contours of wounds. The objective of this study was to assess the aesthetic and wound healing outcomes in full-thickness wounds treated with a combination of MF and MSTSG in a porcine model. APPROACH: Either meshed split-thickness skin grafts (MSTSG) or meshed split-thickness skin graft with MeshFill (MSTSG+MF) was applied to full-thickness excisional wounds in Yorkshire pigs. Wound healing outcomes were assessed using histology, immunohistochemistry, and wound area analysis from day 10 to day 60. Clinical evaluation of wounds was utilized to assess aesthetic outcomes. RESULTS: The results demonstrated that the combination of MSTSGs and MF improved wound healing and aesthetic outcomes. INNOVATION: Effects of MSTSGs and reconstituteable liquid MF in a full-thickness porcine model was investigated for the first time. CONCLUSION: MeshFill provides promise as a combination therapeutic regimen to improve wound healing and aesthetic outcomes.