Background: Cultured allogenic keratinocyte (CAK) and epidermal growth factor (EGF) are commonly used biological treatments for partial-thickness burn wounds. A comparative study was conducted on whether the combination therapy of CAK and EGF promotes partial-thickness burn wound healing.Methods: From January 2020 to March 2021, 73 patients who visited the hospital with partial-thickness burns were enrolled in the study. Patients were treated with CAK (Kaloderm) (n=20), EGF (Easyef) (n=17), and CAK+EGF (n=24). Wound healing rate, time to heal, factors affecting wound healing (age, sex, underlying disease, mode of injury, location of injury, initial wound size), and scarring were comparatively analyzed.Results: The wound healing rate for 20 days was 85% (17/20) in the CAK group, 88% (15/17) in the EGF group, and 92% (22/24) in the CAK+EGF group. The average healing time was 11.0±6.0 days, with the CAK group taking 12.6±5.5 days, EGF group taking 11.5±6.0 days, and CAK+EGF group taking 9.0±6.3 days. The patients who received CAK+EGF treatment had higher hazard than the patients without CAK+EGF treatment (hazard ratio, 2.078; 95% confidence interval, 1.021–4.228). Smaller wound size <5 cm2 (hazard ratio, 2.869; 95% confidence interval, 1.426–5.773) was associated with complete wound healing. Though statistically insignificant (P=0.218), less scars occurred in the CAK+EGF group.Conclusion: Combination therapy of CAK and EGF promotes wound healing in partial-thickness burn wounds.
Background: Though composite grafting is an easy, simple treatment for fingertip amputation, it is known to have a low survival rate. To increase the likelihood of composite graft survival, various adjuvant therapies such as hyperbaric oxygen therapy, ice-cooling, or vasodilator agents have been used. In this study, we attempted to validate the hypothesis that topical normobaric oxygen therapy (tNBO) could improve composite graft survival in fingertip amputation.Methods: Patients who sustained fingertip amputations and who were treated with composite grafting between January 2015 and July 2020 were included. The patients (n=154) were divided into two groups: those who received tNBO (n=102) and those who had not (n=52). The effect of tNBO on graft survival, survival rate by level of amputation, and risk factors of graft survival (age, smoking, time to surgery, diabetes mellitus, and crush-avulsion injury type) were examined.Results: tNBO significantly increased composite graft survival (75.3% vs. 50%, P<0.001) in amputations distal to the nail base area. Among risk factors, time to surgery >5 hours (odds ratio, 48.6; P=0.001) and crush-avulsion injury type (odds ratio, 10.1; P<0.001) significantly decreased graft survival in both groups. Smoking decreased graft survival only in the non-tNBO group (odds ratio, 28; P=0.015), not in the tNBO-treated group.Conclusion: tNBO increased composite graft survival in fingertip amputation distal to the nail base area. It can be helpful for composite graft survival in smokers.
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