Our purpose was to conduct a prospective randomized trial to compare the Versajet system (Smith & Nephew, London, UK) vs hand-held dermatome escharectomy for burn débridment. All patients admitted over the course of 1 year at our burn center were recruited and randomly assigned to Versajet or hand-held dermatome escharectomy. We evaluated the 1) time for complete débridment and 2) the efficacy of Versajet in reaching the correct dermal plane. Secondary end points were the assessment of postoperative pain (evaluated with the visual analog scale), adverse effects, complete healing times, and contractures rates (after 6 months). A total of 87 patients were analyzed in two homogeneous groups of 42 (Versajet) and 45 (escharectomy) patients. All of them received adequate débridment, but the Versajet procedure was faster (P < .05) and more precise in obtaining the correct plane. One Versajet patient required ligation of a large subcutaneous vessel, which inadvertently was cut during the procedure. Versajet is a feasible, simple, and safe technique that hastens surgical débridment of burns and adds more precision to the procedure.

The overall incidence of complications in our series was relatively high (4.6%). Surgical placement of prostheses and the technique used for pocket creation were associated with complications. However, few patients required reoperation (1.6%), and the overall satisfaction rate was acceptable (visual analog score, 7).

The incidence of infections in aesthetic breast augmentations is 1.1%, and Mentor prostheses, antibiotics in the pocket, and the use of drains seem associated with their occurrence.

The incidence of infections in post-bariatric patients undergoing body contouring abdominoplasties is 25%. The relative risk conferred by smoking was 14 and the cut-off value was 62,000 overall cigarettes (8.5 pack years).

Since 2001, Hyalomatrix PA (Fidia Advanced Biopolymers, Abano Terme, Italy) has been used in our center on pediatric burned patients as a temporary dermal substitute to cover deep partial-thickness burns after dermabrasion. This "bridge" treatment was adopted to remove necrotic debris (dermabrasion) and to stimulate regeneration in a humid and protected environment (Hyalomatrix PA). We present results obtained with this approach. On the third to fifth day after admission, dermabrasion was practiced on deep burned areas, which were covered with Hyalomatrix PA. Change of dressings was performed every 7 days. On day 21, those areas still without signs of recovery were removed with classic escharectomy and covered with thin skin grafts. We treated 300 patients. Sixty-one percent needed only one dermabrasion treatment, 22.3% (67 patients) more than one, and 16.7% (50 patients) the classic escharectomy. A total of 83% of patients healed within 21 days. Our study suggests that the combination of dermabrasion with a temporary dermal substitute could be a good and feasible approach for treatment of deep partial-thickness burns. Prospective randomized studies are now necessary to compare our protocol with the gold standard treatment of topical dressings.