The pre-clinical evaluation of a synthetic fibrin-alginate dermal scaffold : the Smart Matrix™

Abstract

Cutaneous wound management remains challenging. A synthetic fibrin/alginate dermal scaffold, Smart Matrix (SM), demonstrated rapid short term vascularisation and skin graft (STSG) integration. Long term healing using SM+STSG was examined in the porcine model. SM+STSG was compared to STSG alone and secondary intention healing in simple wounds, before being compared to commercially available scaffolds - Matriderm and Integra. The value of such adjuncts lies in their ability to heal attenuated wounds. The medical literature revealed few appropriate wound models. The partial excision of a full thickness burn was described and compared with the full thickness excision wound. This model was then used to evaluate SM+STSG and compare it with STSG alone and MD+STSG. SM wounds contracted less than other wound groups with lower levels of contractile markers. Graft take was similar in all simple wounds but increased in attenuated wounds treated with SM and MD. SM wounds showed increased earlier angiogenesis, similar to normal skin in the long term, with lower inflammation than STSG alone and I+STSG wounds. Scaffold persistence was shortest for SM+STSG and prolonged in all groups in the attenuated model. There were no long term differences between SM and MD in acute and attenuated wounds apart from contraction. The attenuated wound healing model displayed delayed epithelialisation and angiogenesis with prolonged oedema and inflammation. Fibrin attenuates -SMA formation, decreasing myofibroblast differentiation and therefore reducing wound contraction. SM supports long term healing, with reduced wound contraction and inflammation in simple and attenuated wounds.