Prevalence and Risk Factors for Hypertrophic Scarring of Split Thickness Autograft Donor Sites in a Pediatric Burn Population

Rotatori, R. Maxwell; Starr, Brian; Peake, Mitchell; Fowler, Luke; James, Laura E.; Nelson, J. Lee; Dale, Elizabeth

doi:10.1016/j.burns.2019.02.003

Cited by 19 publications

(21 citation statements)

References 42 publications

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“…48 The dHACM results describing time to healing and complications with HTS/contractures were compared with results from previously described STSG studies. [49][50][51][52][53][54][55][56] The time to healing for dHACM on average was less than STSG, as it took 15-21 days to heal the various depths of burns while STSG took on average >21 days, as demonstrated in Table 5. The rates of HTS and contractures of dHACM grafts were compared with eight representative studies describing STSG.…”

Section: Resultsmentioning

confidence: 99%

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Dehydrated Human Amnion Chorion Membrane as Treatment for Pediatric Burns

Ahuja

Jin

Powers

et al. 2020

Advances in Wound Care

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Pediatric burns are a major source of injury and in the absence of adequate care can lead to lifelong functional loss and disfigurement. While split thickness skin autografts are the current standard of care for deep partial and full-thickness burns, this approach is associated with considerable morbidity. For this reason, alternative skin substitutes such as allografts have gained interest. Approach: In the present study, we present a case series of 30 children with various types of burns treated with dehydrated human amnion chorion membrane (dHACM). Results: We show that treatment with dHACM is associated with an excellent rate of healing comparable to split thickness skin grafts with less rate of hypertrophic scar and contracture. Innovation: Treatment with dHACM is particularly attractive as it consists of many tissue regenerative factors, such as growth factors and immune modulators, thus it will reduce the risk of scaring. Conclusion: While dHACM is associated with an increased upfront cost, treating patients with small to moderate-sized burns with dHACM in their regional centers works to decrease downstream costs such as management of prolonged pain from donor-site morbidity, revisional surgeries from scar and contractures of split thickness grafts, and avoiding the cost of transfer to higher level centers of care. Our findings challenge the current standard of care, suggesting that dHACM provides an alternative to the current use of split thickness skin grafting and is a safe, feasible, and potentially superior substitute for the management of small to moderate total body surface area partial and full-thickness pediatric burns.

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Section: Resultsmentioning

confidence: 99%

“…The literature was reviewed for time to healing of STSG based on depth of burn wound. [48][49][50][51][52][53][54][55] These results were tabularized, and were compared with rates of healing for dHACM grafts dependent on depth of burn wound.…”

Section: Methodsmentioning

confidence: 99%

Dehydrated Human Amnion Chorion Membrane as Treatment for Pediatric Burns

Ahuja

Jin

Powers

et al. 2020

Advances in Wound Care

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“…While morbidities such as pain and scars are common, the infection rate seems to be low [113]. Almost no findings are available on the prevalence of hypertrophic scars associated with donor site [114,115]. According to retrospective analyses, 34% of reviewed patients were affected by persistent hypertrophic scarring [114].…”

Section: The Curse Of Donor Site Morbiditymentioning

confidence: 99%

Historical Evolution of Skin Grafting—A Journey through Time

et al. 2021

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Autologous skin grafting was developed more than 3500 years ago. Several approaches and techniques have been discovered and established in burn care since then. Great achievements were made during the 19th and 20th century. Many of these techniques are still part of the surgical burn care. Today, autologous skin grafting is still considered to be the gold standard for burn wound coverage. The present paper gives an overview about the evolution of skin grafting and its usage in burn care nowadays.

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“…When looking at the risk factors that lead to pathologic scarring after burn injury, the exhaustive multivariate review of 703 patients by Gangemi et al [7] reveals that female sex, younger age, burn sites on the neck or upper limbs, multiple surgical procedures, and meshed skin grafts were independent risk factors that contributed to increased incidence. In pediatric burn injury, Rotatori et al [8] reviewed 237 patients and found an astounding 64% with HTS. Specific risk factors for HTS included Hispanic ethnicity, increased total burn area, increased depth of injury, and increased percentage of burn requiring skin autografting.…”

Section: Epidemiology Of Scarring After Burn Injurymentioning

confidence: 99%

“…Specific risk factors for HTS included Hispanic ethnicity, increased total burn area, increased depth of injury, and increased percentage of burn requiring skin autografting. Risk factors involved in developing donor site HTS were increased time of epithelialization, increased depth of skin harvest, and thigh as the anatomical donor [8] .…”

Section: Epidemiology Of Scarring After Burn Injurymentioning

confidence: 99%

Prevention and management of scarring after thermal injury

Wong¹,

Lin²,

Ding³

et al. 2021

PAR

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Survival from burn injury has improved considerably over the past two decades such that the quality of life of the victim of thermal injuries has become a major concern. Severe proliferative scarring or hypertrophic scarring (HTS) is an all too frequent complication of burn wound healing that severely compromises quality of life for surviving burn victims. Prevention of such scarring in burn patients involves better understanding of the pathophysiology of scar formation, development of newer methods for determining depth of burn injury and earlier and advanced surgical interventions. Many established and evolving novel treatments for HTS in patients after thermal injury exist and include antifibrotic pharmaceuticals and cellular-based therapies as reviewed herein.

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Prevalence and Risk Factors for Hypertrophic Scarring of Split Thickness Autograft Donor Sites in a Pediatric Burn Population

Cited by 19 publications

References 42 publications

Dehydrated Human Amnion Chorion Membrane as Treatment for Pediatric Burns

Dehydrated Human Amnion Chorion Membrane as Treatment for Pediatric Burns

Historical Evolution of Skin Grafting—A Journey through Time

Prevention and management of scarring after thermal injury

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