Ryan E Austin1, Nishant Merchant2, Shahriar Shahrokhi3, Marc G Jeschke4. 1. Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Toronto, 149 College St, Stewart Building, 5th Floor, Toronto, ON M5T 1P5, Canada; Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, D704, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Electronic address: ry.austin@mail.utoronto.ca. 2. Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, D704, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Electronic address: merchant.nishant@gmail.com. 3. Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Toronto, 149 College St, Stewart Building, 5th Floor, Toronto, ON M5T 1P5, Canada; Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, D704, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Electronic address: shar.shahrokhi@sunnybrook.ca. 4. Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Toronto, 149 College St, Stewart Building, 5th Floor, Toronto, ON M5T 1P5, Canada; Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, D704, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Electronic address: marc.jeschke@sunnybrook.ca.
Abstract
INTRODUCTION: In many circumstances early burn excision and autografting is unsafe or even impossible. In these situations, skin substitute dressings can be utilized for temporary wound coverage. Two commonly used dressings for this purpose are cadaveric allograft and Biobrane™. MATERIALS AND METHODS: Five year retrospective cohort study evaluating upper extremity burns treated with temporary wound coverage (Biobrane™ or allograft). The primary outcome was to determine the impact choice of wound coverage had on operative time and cost. The secondary outcome was the need for revision of upper extremity debridement prior to definitive autografting. RESULTS: 45 patients were included in this study: 15 treated with cadaveric allograft and 30 treated with Biobrane™ skin substitute. Biobrane™ had a significantly lower procedure time (21.12 vs. 54.78 min per %TBSA excised, p=0.02) and cost (1.30 vs. 2.35 dollars per minute per %TBSA excised, p=0.002). Both techniques resulted in 2 revisions due to complications. CONCLUSION: Biobrane™ is superior to cadaveric allograft as a temporizing skin substitute in the acute burn wound, both in terms of procedure time and associated cost. We believe that this is largely due to the relative ease of application of Biobrane™. Furthermore, given its unique characteristics, Biobrane™ may serve as a triage and transport option for severe burns in the military and mass casualty settings.
INTRODUCTION: In many circumstances early burn excision and autografting is unsafe or even impossible. In these situations, skin substitute dressings can be utilized for temporary wound coverage. Two commonly used dressings for this purpose are cadaveric allograft and Biobrane™. MATERIALS AND METHODS: Five year retrospective cohort study evaluating upper extremity burns treated with temporary wound coverage (Biobrane™ or allograft). The primary outcome was to determine the impact choice of wound coverage had on operative time and cost. The secondary outcome was the need for revision of upper extremity debridement prior to definitive autografting. RESULTS: 45 patients were included in this study: 15 treated with cadaveric allograft and 30 treated with Biobrane™ skin substitute. Biobrane™ had a significantly lower procedure time (21.12 vs. 54.78 min per %TBSA excised, p=0.02) and cost (1.30 vs. 2.35 dollars per minute per %TBSA excised, p=0.002). Both techniques resulted in 2 revisions due to complications. CONCLUSION: Biobrane™ is superior to cadaveric allograft as a temporizing skin substitute in the acute burn wound, both in terms of procedure time and associated cost. We believe that this is largely due to the relative ease of application of Biobrane™. Furthermore, given its unique characteristics, Biobrane™ may serve as a triage and transport option for severe burns in the military and mass casualty settings.
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