Herbert L Haller1, Sigrid E Blome-Eberwein2, Ludwik K Branski3, Joshua S Carson4, Roselle E Crombie5, William L Hickerson6, Lars Peter Kamolz7, Booker T King8, Sebastian P Nischwitz7, Daniel Popp7, Jeffrey W Shupp9, Steven E Wolf2. 1. HLMedConsult, Zehetlandweg 7, 4060 Leonding, Austria. 2. Lehigh Valley Health Network 1200 S. Cedar Crest Blvd. Kasych 3000, Allentown, PA 18103, USA. 3. Department of Surgery-Burn Surgery, The University of Texas Medical Branch and Shriners Hospitals for Children, 301 University BLVD, Galveston, TX 77555, USA. 4. Department of Surgery, UF Health Shands Burn Center, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USA. 5. Connecticut Burn Center, Yale New Haven Heal System, 267 Grant St, Bridgeport, CT 06610, USA. 6. Memphis Medical Center Burn Center, 890 Madison Avenue, Suite TG032, Memphis, TN 38103, USA. 7. Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University, 8053 Graz, Austria. 8. Division of Burn Surgery, Department of Surgery, 101 Manning Drive CB #7206, Chapel Hill, NC 27599, USA. 9. The Burn Center, Department of Surgery, MedStar Washington Hospital Center, 110 Irving St NW, Washington, DC 20010, USA.
Abstract
Background and Objectives: Porcine xenografts have been used successfully in partial thickness burn treatment for many years. Their disappearance from the market led to the search for effective and efficient alternatives. In this article, we examine the synthetic epidermal skin substitute Suprathel® as a substitute in the treatment of partial thickness burns. Materials and Methods: A systematic review following the PRISMA guidelines has been performed. Sixteen Suprathel® and 12 porcine xenograft studies could be included. Advantages and disadvantages between the treatments and the studies' primary endpoints have been investigated qualitatively and quantitatively. Results: Although Suprathel had a nearly six times larger TBSA in their studies (p < 0.001), it showed a significantly lower necessity for skin grafts (p < 0.001), and we found a significantly lower infection rate (p < 0.001) than in Porcine Xenografts. Nonetheless, no significant differences in the healing time (p = 0.67) and the number of dressing changes until complete wound healing (p = 0.139) could be found. Both products reduced pain to various degrees with the impression of a better performance of Suprathel® on a qualitative level. Porcine xenograft was not recommended for donor sites or coverage of sheet-transplanted keratinocytes, while Suprathel® was used successfully in both indications. Conclusion: The investigated parameters indicate that Suprathel® to be an effective replacement for porcine xenografts with even lower subsequent treatment rates. Suprathel® appears to be usable in an extended range of indications compared to porcine xenograft. Data heterogeneity limited conclusions from the results.
Background and Objectives: Porcine xenografts have been used successfully in partial thickness burn treatment for many years. Their disappearance from the market led to the search for effective and efficient alternatives. In this article, we examine the synthetic epidermal skin substitute Suprathel® as a substitute in the treatment of partial thickness burns. Materials and Methods: A systematic review following the PRISMA guidelines has been performed. Sixteen Suprathel® and 12 porcine xenograft studies could be included. Advantages and disadvantages between the treatments and the studies' primary endpoints have been investigated qualitatively and quantitatively. Results: Although Suprathel had a nearly six times larger TBSA in their studies (p < 0.001), it showed a significantly lower necessity for skin grafts (p < 0.001), and we found a significantly lower infection rate (p < 0.001) than in Porcine Xenografts. Nonetheless, no significant differences in the healing time (p = 0.67) and the number of dressing changes until complete wound healing (p = 0.139) could be found. Both products reduced pain to various degrees with the impression of a better performance of Suprathel® on a qualitative level. Porcine xenograft was not recommended for donor sites or coverage of sheet-transplanted keratinocytes, while Suprathel® was used successfully in both indications. Conclusion: The investigated parameters indicate that Suprathel® to be an effective replacement for porcine xenografts with even lower subsequent treatment rates. Suprathel® appears to be usable in an extended range of indications compared to porcine xenograft. Data heterogeneity limited conclusions from the results.
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