A new option for definitive burn wound closure – pair matching type of retrospective case–control study of hand burns in the hospitalised patients group in the Dr Stanislaw Sakiel Centre for Burn Treatment between 2009 and 2015

Abstract

Nearly 80% of all burns include the hands of affected individuals. Skin grafting is the gold standard in burns treatment, but in the case of the burn wound bed, it may require the necessity of utilising skin substitutes to facilitate closure. The aim of this study is to assess the impact of a porcine-derived wound dressing (Oasis™) for application to hand burns compared to a synthetic dressing (Suprathel™). Comparative assessments were made, including the time to heal, quality of healing and pain intensity. A retrospective, unblinded, matching pair case-control of hand burns was performed. A control group of 24 patients was treated with Suprathel dressing, and a study group of six patients underwent application of the Oasis dressing. The wound healing process was evaluated by taking histopathological specimens and also utilising the Bates-Jensen Wound Assessment Tool. A 10-cm Visual Analogue Scale (VAS) was used for pain assessment. Other parameters measured included dressing loss because of infection and the need of rehabilitation. The progress of wound healing on the fourth day in the study group was 30%. A decrease in the level of pain was recorded on the fourth day after surgery. There was a decrease of 5% in the risk of rehabilitation in the treatment group.

A new approach to the production of a biovital skin graft based on human acellular dermal matrix produced in‐house, in vitro revitalized internally by human fibroblasts and keratinocytes on the surface

“…The optimal method of treatment for extensive full‐thickness skin burns (III°) is to perform an autologous split‐thickness skin graft (STSG) donated from a body part with intact skin (Busuioc et al, ; Glik et al, ; Grossova, Zajicek, Kubok, & Smula, ; Kitala et al, ; Prim et al, ). However, despite total tissue compliance, which should be considered the main advantage of STSG, such grafts have a number of disadvantages and limitations (Kitala et al, ; Table , Figure a).…”

“…However, despite total tissue compliance, which should be considered the main advantage of STSG, such grafts have a number of disadvantages and limitations (Kitala et al, ; Table , Figure a). In order to overcome these limitations, the application of biological skin substitutes may be considered (Glik et al, ; Kitala et al, ), the advantage of which may be, for example, the reduction of the donor site surface area and shortening the time of hospitalization of burn patients (Kitala et al, ).…”

Porcine Xenograft and Epidermal Fully Synthetic Skin Substitutes in the Treatment of Partial-Thickness Burns: A Literature Review

“…Wong–Baker and Comfort B scores used by Glat et al [ 7 ] and Rashaan et al [ 16 ] showed values between no pain and minimal pain after ST treatment. Glik et al [ 8 ] showed OASIS superior only on day four without statistical significance.…”

“…Burn severity might also influence hospital LOS, which could not be considered due to insufficient data. In prospective ST and PX studies, hospital LOS ranged from 0 [ 5 ] to 23.3 days [ 9 ] and 2 to approximately 40 days [ 8 ], respectively.…”

“…So far, ST ® has been used as a temporization product, although with insufficient evidence. In deep dermal burns, where there is limited availability of donor areas, mono-and bilayer dermal regeneration templates [91][92][93] of biological or biosynthetic or fully synthetic origin [94] can help bridge the time until skin grafts or cultured epithelial autografts or dermal-epidermal substitutes [8,[95][96][97][98] are available again. Other methods use pathogenfree human keratinocyte progenitor cells to replace autologous epidermal cells [99] and can be used immediately, as demonstrated in traumatic wounds [100].…”