Abstract:Objective To study the application of artificial dermal scaffold in treatment of large area avulsion injury. Methods The clinical data of twenty inpatients with large area avulsion injury who were treated in the Department of Burn and Trauma Surgery of Changhai Hospital between January 2011 and December 2014 were retrospectively analyzed in this study. The 20 patients, aged 6-68 years old and with avulsion area of 10%-40% total body surface area (TBSA), were divided into 2 groups according to treatments, with ten cases in each group. The wounds in the treatment group were treated with debridement plus artificial dermal scaffold plus Negative Pressure Wound Therapy (NPWT); NPWT was changed 5-7 days and the vascularization was observed. The wounds in control group were treated with debridement plus NPWT, and autograft implant surgery was done in both groups according to the vascularization degrees. The time intervals from debridement to skin grafting, the survival rate of the skin-graft, and the healing time and quality of the donor area were all observed. Results Compared with the control group, the treatment group exhibited a significantly longer time interval from debridement to skin grafting([13.30±2.06] d vs[7.90±1.10] d, P<0.05), a significantly shorter healing time ([8.10±0.99] d vs[13.10±1.10] d, P<0.05), and a better healing quality (4.40±1.58 vs 7.80±1.14, P<0.05) in the donor sites. While at the recipient sites, there were no significant differences in the survival rate of the skin-graft([87.30±5.27]% vs[85.10±5.53]%), or the healing time([17.80±1.14] d vs[18.70±2.06] d) and quality(8.40±1.07 vs 9.00±1.05) between the two groups (P>0.05). Conclusion Early application of artificial dermal scaffold combined with NPWT for treatment of large area avulsion injury can avoid large grafting and reduce trauma, which can help to keep patients in stable status; meanwhile it can promote vascularization process and improve the healing time and quality of wounds, especially in the donor sites.