BACKGROUND: In our preliminary experiments we found that composite skin grafts consisting of allogeneic acellular dermis and thin epidermal autologous grafts applied to the excised burn wound in one stage led to better results in terms of viscoelastic properties than autologous split-thickness skin grafts. PATIENTS AND METHODS: In ten burn patients we applied composite skin grafts consisting of allogeneic acellular dermis and thin epidermal autologous grafts and followed the quality of the reconstructed skin cover with a special device, Cutometer MPA 580, over a period of four years. RESULTS: The cutometric curves demonstrated better viscoelastic properties in composite skin grafts than in conventional split-thickness skin grafts after four years. We found Cutometer MPA 580 to be an advantageous device for the objectification of improved quality of reconstructed skin cover. DISCUSSION: Among the various methods the cutometer showed the advantage of being a non-invasive, precise, and objective method of measuring skin's viscoelastic properties. The Vancouver Scar Score is a subjective evaluation of skin viscoelasticity. CONCLUSION: Our prospective clinical study clearly demonstrated that cutometric measurement produced objective results in contrast to clinical evaluation, the Vancouver Scar Score, and other non-quantitative methods. Our hypothesis that composite skin grafts consisting of allogeneic acellular dermis and thin epidermal autologous grafts applied onto the excised burn wound in one stage led to better results in terms of viscoelastic properties than autologous split-thickness skin grafts was fully confirmed.

Department of Burns and Reconstructive Surgery Brno University Hospital Brno Czech Republic