Analysis of the effectiveness of decellularized allogeneic dermis combined with autologous split-thickness skin graft in repairing scar contracture in children's joint areas.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 42508096.
- Also identified by DOI 10.1016/j.burns.2026.108145.
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Abstract
To assess the clinical effectiveness and safety of decellularized allogeneic dermis combined with autologous split-thickness skin graft in repairing scar contractures in children's joint areas, with attention to recipient-site healing, joint function, and donor-site morbidity. A retrospective cohort study was performed on 127 children treated from July 2014 to June 2024. The observation group (n = 74) received composite grafting, while the control group (n = 53) underwent autologous thick split-thickness skin graft alone. Perioperative indicators and 12-month outcomes were analyzed using multivariate regression to adjust for baseline differences. The observation group was younger and had larger wound areas (both P < 0.05). Donor site healing time was significantly shorter (6.91 ± 0.29 days vs. 10.26 ± 2.60 days, P < 0.001), and donor site Vancouver Scar Scale scores were zero at both 6 and 12 months (both P < 0.001). The observation group was younger and had larger wound areas. Donor-site healing time was significantly shorter in the observation group, and donor-site VSS scores remained minimal during follow-up. At the recipient site, scar scores improved over time in both groups, but the degree of improvement did not differ significantly between groups. Joint range of motion recovered satisfactorily in both groups, and complication rates were similar. Decellularized allogeneic dermis combined with an autologous split-thickness scalp graft is a feasible reconstructive option for pediatric joint scar contractures. In this cohort, its main advantage was faster donor-site healing with minimal visible donor-site scarring. Recipient-site scar improvement, graft survival, joint range of motion, and complication rates were comparable with those of autologous grafting alone. These findings should be interpreted cautiously because of the retrospective design and baseline differences between groups. The shorter donor-site healing time observed in this group is best regarded as an expected advantage of thin scalp harvesting rather than an independent effect of the dermal substitute.