A.M. Soo Ping Chow1,2,3, T.D. Le1, B.C. Carney1,3,4, L.T. Moffatt1,3,4, T.E. Travis1,2,3,5, J.W. Shupp1,2,3,4,5, S. Tejiram1,2,3,5 1MedStar Health Research Institute, Firefighters’ Burn And Surgical Research Laboratory, Washington, DC, USA 2Washington Hospital Center, The Burn Center, Washington, DC, USA 3Georgetown University Medical Center, Department Of Surgery, Washington, DC, USA 4Georgetown University Medical Center, Department Of Biochemistry And Molecular & Cellular Biology, Washington, DC, USA 5Georgetown University Medical Center, Department Of Plastic And Reconstructive Surgery, Washington, DC, USA
Introduction:
Partial-thickness burn injury is associated with significant pain, wound care needs, and both economic and psychological impact. Attention has shifted to dressings with long-term form and function with a focus on restoration of protective skin function. A synthetic, biodegradable copolymer DL-lactide membrane has been introduced as an optimal burn wound dressing with advantages in infectious control, fit, form, affordability, and aesthetics. However, a paucity of literature exists regarding its efficacy compared to standard of care dressings for partial-thickness injuries. This study aims to the compare the treatment effects of this synthetic skin substitute to standard of care silver-based dressings in patients with partial thickness burns.
Methods:
Patients admitted to a regional burn center from November 2022 to October 2023 with partial thickness burns were retrospectively reviewed for those who underwent treatment with a synthetic skin substitute compared to those who received standard of care with a silver-based dressing (silver sulfadiazine or Mepilex® Ag). Data collected included patient demographics, burn injury characteristics, and their hospital course. Outcomes of interest were hospital length of stay, time to wound healing, complications, readmission, and need for autografting.
Results:
One hundred and thirty-six patients (skin substitute, n=67; silver-based dressing, n=69) were included. There were no statistically significant differences in age and sex between the groups. Mean ( SD) age was 47.5 years (17.7). The most common burn etiology was scald (58.1%), with no significant differences between the groups. Mean TBSA burn was larger in the patients receiving a synthetic skin substitute compared to silver-based dressings (6.0% vs 2.8%, p<0.0001), but there was no difference in the burn depth (p=0.21). One patient (1.5%) required readmission for autografting to areas treated with a skin substitute. Of the patients treated with a silver-based dressing, three patients (4.3%) required readmission for wound care, and one required an autograft. Four patients treated with a silver-based dressing developed cellulitis requiring antibiotics compared to none in the skin substitute cohort (p<0.05). Logistic regression analysis demonstrated no difference among groups in wound healing within 30 days of injury (p=0.51) and time to healing (p=0.35) after controlling for TBSA. In patients who were treated with a silver-based dressing, mean hospital length of stay was 2.48 days (2.7), whereas mean length of stay after placement of the skin substitute was less than one day [0.85 (1.8), p<0.01].
Conclusion:
In partial thickness burns, a synthetic skin substitute yielded comparable rates of healing to silver-based dressings, decreased incidence of complications, and shorter hospital length of stay. Further study will be necessary to better elucidate the use of this product compared to standard silver based wound care.