BACKGROUND: Tangential excision and autologous skin graft coverage is a foundational principle in burn surgery. Fibrin sealant (Artiss®) was developed recently as alternative to staples for graft fixation. The aim of this study was to assess whether graft-fixation with Artiss shows profit in terms of postoperative pain management compared to graft fixation with staples. METHODS: A retrospective single-center, single-surgeon frequency-matched cohort study was completed on 83 patients with thermal injury burns covering 1%-25% of total body surface area, requiring early excision and immediate coverage with split-thickness skin grafts. Grafts were fixated with Artiss only or staples only. Primary outcome parameters include complication rates (graft loss, need for regrafting and wound contamination), the requirement of pain medication for postoperative pain and the need for narcosis for postoperative procedures. RESULTS: Graft-fixation with Artiss resulted in a decrease in administration of analgesics (P=0.005) and anesthetics (P=0.007) postoperatively. No statistically significant difference was found in complication rates (P=0.999) between both groups. CONCLUSION: Fibrin sealant proved to be a safe and effective alternative to staples for graft fixation. It showed profit in short-term burn outcomes, reducing the need for analgesics and anesthetics postoperatively. IJBT
BACKGROUND: Tangential excision and autologous skin graft coverage is a foundational principle in burn surgery. Fibrin sealant (Artiss®) was developed recently as alternative to staples for graft fixation. The aim of this study was to assess whether graft-fixation with Artiss shows profit in terms of postoperative pain management compared to graft fixation with staples. METHODS: A retrospective single-center, single-surgeon frequency-matched cohort study was completed on 83 patients with thermal injury burns covering 1%-25% of total body surface area, requiring early excision and immediate coverage with split-thickness skin grafts. Grafts were fixated with Artiss only or staples only. Primary outcome parameters include complication rates (graft loss, need for regrafting and wound contamination), the requirement of pain medication for postoperative pain and the need for narcosis for postoperative procedures. RESULTS: Graft-fixation with Artiss resulted in a decrease in administration of analgesics (P=0.005) and anesthetics (P=0.007) postoperatively. No statistically significant difference was found in complication rates (P=0.999) between both groups. CONCLUSION: Fibrin sealant proved to be a safe and effective alternative to staples for graft fixation. It showed profit in short-term burn outcomes, reducing the need for analgesics and anesthetics postoperatively. IJBT
Authors: Ludwik K Branski; Rainer Mittermayr; David N Herndon; Marc G Jeschke; Martina Hofmann; Oscar E Masters; William B Norbury; Daniel L Traber; Stefan Tangl; Heinz Redl Journal: Burns Date: 2011-05-06 Impact factor: 2.744