BACKGROUND: The purpose of dermal substitutes is to mimic the basic properties of the extracellular matrix of human skin. The application of dermal substitutes to the defect reduces the formation of hypertrophic scars and improves the scar quality. This study aims to develop an original dermal substitute enriched with stable fibroblast growth factor 2 (FGF2-STAB®) and test it in an animal model. METHODS: Dermal substitutes based on collagen/chitosan scaffolds or collagen/chitosan scaffolds with nanofibrous layer were prepared and enriched with FGF2-STAB® at concentrations of 0, 0.1, 1.0, and 10.0 µg ‧ cm-2. The performance of these dermal substitutes was tested in vivo on artificially formed skin defects in female swine. The outcomes were evaluated using cutometry at 3 and 6 months. In addition, visual appearance was assessed based on photos of the scars at 1-month, 3-month and 6-month follow-ups using Yeong scale and Visual Analog Scale. RESULTS: The dermal substitute was fully integrated into all defects and all wounds healed successfully. FGF2-STAB®-enriched matrices yielded better results in cutometry compared to scaffolds without FGF2. Visual evaluation at 1, 3, and 6 months follow-ups detected no significant differences among groups. The FGF2-STAB® effectiveness in improving the elasticity of scar tissues was confirmed in the swine model. This effect was independently observed in the scaffolds with nanofibres as well as in the scaffolds without nanofibres. CONCLUSION: The formation of scars with the best elasticity was exhibited by addition 1.0 µg ‧ cm-2of FGF2-STAB® into the scaffolds, although it had no significant effect on visual appearance at longer follow-ups. This study creates the basis for further translational studies of the developed product and its progression into the clinical phase of the research.

CEITEC Central European Institute of Technology Brno University of Technology Purkynova 123 612 00 Brno Czech Republic

Department of Burns and Plastic Surgery Institution Shared with the University Hospital Brno Faculty of Medicine Jihlavská 20 625 00 Brno Czech Republic

Department of Burns and Plastic Surgery Institution Shared with the University Hospital Brno Faculty of Medicine Jihlavská 20 625 00 Brno Czech Republic; CEITEC Central European Institute of Technology Brno University of Technology Purkynova 123 612 00 Brno Czech Republic

Department of Burns and Plastic Surgery Institution Shared with the University Hospital Brno Faculty of Medicine Jihlavská 20 625 00 Brno Czech Republic; Clinic of plastic and esthetic surgery St Anne's University Hospital Pekarska 664 53 602 00 Brno Czech Republic

Enantis s r o Kamenice 771 34 625 00 Brno Czech Republic

Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Kamenice 735 5 625 00 Brno Czech Republic

Veterinary Research Institute Hudcova 296 70 621 00 Brno Czech Republic

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