▶ Previous Artlcle : #17-1. Lactocapromer Terpolymer Matrix (Suprathel)
Effect of lactate on wound healing
In the recent years, biodegradable lactocapromer terpolymer matrices have been used as epidermal substitutes. They are known to effectively prevent progression of superficial burns into deep burns. Suprathel is a commercialized lactocapromer terpolymer matrix with the active ingredient of DL-Lactate which acts as lactate in the physiological environment. More closely, lactate promotes wound healing largely in the following three mechanisms.
First, lactate increases the acidity of the wound (to hydrogen exponent of pH4). This increases the oxygen saturation of the wound tissue, thereby accelerating the healing process and protecting the skin with antimicrobial effect. Second, lactate stimulates dermal regeneration with fibroblast migration and collagenesis. Third, lactate induces vascularization in anaerobic conditions. As it promotes re-epithelization, it has been shown to be especially beneficial in uninfected wounds, pediatric burns, and the donor site in skin graft. Its dense structure creates an environment conducive for wound healing and enhances migration of keratinocytes.
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Tissue perfusion is inhibited within 48 hours of sustaining the wound in burn wounds. The subsequent disturbance of microcirculation inhibits oxygenation and nourishment of the wound site and increases the risk of infection. Inhibited tissue perfusion extends the area of damage and impedes the healing process. Therefore, immediately after a wound is sustained, application of Suprathel is recommended to maintain microcirculation and prevent second degree burns progressing into deeper buns. Indications of Suprathel include the following.
1) Second-degree or deep burns and complicated wounds
2) Donor site coverage during split-thickness skin graft
3) Deep or extensive abrasive injury
4) Soft tissue damage in avulsion injury
5) Surgical scar removal and coverage of grafted skin.
Advantages of Lactocapromer Terpolymer Matrix
Histological examination of biopsy specimen taken 14 days after Suprathel application showed no inflammatory reaction. Moreover, formation of abundant vascularized granulation tissues from enhanced capillary activity, as well as increased extracellular matrix and formation of stratum basale have been reported.
Unique benefits of lactocapromer terpolymer matrix over other wound coverage materials are as following.
First, autograft, allograft or xonograft can be avoided, which reduces the cost of treatment. Second, antibacterial action reduces infection. Third, it can promote fast recovery even in full-thickness or deep skin defects. Finally, it reduces scarring by enhancing wound healing and brings excellent aesthetic outcomes.
References
Ring A, Tilkorn D, Ottomann C, Geomelas M, Steinstraesser L, Langer S, Goertz O. Intravital monitoring of microcirculatory and angiogenic response to lactocapromer terpolymer matrix in a wound model. Int Wound J. 2011 Apr;8 (2):112-7.
Uhlig C, Rapp M, Hartmann B, Hierlemann H, Planck H, Dittel KK. Suprathel-an innovative, resorbable skin substitute for the treatment of burn victims. Burns. 2007 Mar;33 (2):221-9.
-To be continued-
