The Treatment of Bone Exposure in Burns by Using Artificial Dermis

Background: The treatment of bone-exposed wounds with artificial dermis is not widely accepted in burn patients because of uncertain clinical results. This article aimed to review our clinical experience with this technique. Methods: We implanted artificial dermis in 11 bone-exposed burns. Implantation was directly performed on bones with periosteum, whereas bones without periosteum were trephinated or burred before implantation. All wounds were closed by secondary skin grafting. Results: The mean patient age was 49 years. Lower extremity is the most common site of bone exposure. The mean bone exposed area was 55.6 cm(2), whereas the mean Integra-implanted area was 86.7 cm(2). The overall implant take rate was 91%, and the skin grafting success rate was 80%. No secondary breakdown was noted after a 2-year follow-up. Conclusions: This study confirms that artificial dermis can be an alternative treatment tool for burns with exposed bones, especially in patients with limited donor sites.