Cultured epidermal autograft and the treatment of the massive burn injury

The Journal of Burn Care & Rehabilitation
L R HaithW T Goldman

Abstract

As a rule, adult and pediatric patients with thermal injuries that involve more than 90% total body surface area (TBSA) burn have poor prognoses. Even for patients who are 5 to 34 years old with a 70% TBSA burn, the mortality rate is 80%. Lack of autologous donor skin, which is essential for permanent wound closure, is the major problem. Recent advances in growth of cultured epidermal autograft (CEA) have allowed closure of full- and partial-thickness burns; in approximately 3 weeks, a 2 cm2 biopsy specimen will produce enough CEA to cover a pediatric patient. Since 1989, we have used this product on nine patients; the average age was 39, and the average TBSA burn was 70% (range, 44% to 93%). We report our approach to use of CEA in six of these patients, including topical applications of 1% silver sulfadiazine and excision of full- and deep partial-thickness wounds within 2 weeks of injury. Temporary closure was achieved with cadaver allograft. "Take" of the allograft forecasted take of CEA. The total operative time of CEA placement was decreased by a two-step technique that obviates repeating debridement: the technique consists of debriding and grafting with allograft, then removing it at the time of CEA placement. CEA take is...Continue Reading

Citations

May 1, 2007·Regenerative Medicine·Michele De LucaHoward Green
Sep 1, 1997·Pediatric Surgery International·M Meuli, M Raghunath
May 31, 1994·Annals of the New York Academy of Sciences·J P Waymack, R L Rutan
Oct 6, 2012·Seminars in Cell & Developmental Biology·Y BarrandonAriane Rochat
Jun 27, 2012·Clinics in Plastic Surgery·Gerit MulderMayer Tenenhaus
Feb 7, 2009·Annales de chirurgie plastique et esthétique·J-N McHeikG Levard
Sep 11, 2012·International Wound Journal·Liesbeth LootensStan Monstrey
Apr 20, 2006·Burns : Journal of the International Society for Burn Injuries·F M WoodP Allen
Dec 1, 1994·Burns : Journal of the International Society for Burn Injuries·J M StillE J Law
Jul 1, 1992·British Journal of Plastic Surgery·J Nanchahal, C M Ward
Dec 18, 2002·ANZ Journal of Surgery·Michael Elliott, John Vandervord
Sep 26, 2006·Tissue Engineering·M Ehrenreich, Z Ruszczak
Jul 10, 2010·Journal of Burn Care & Research : Official Publication of the American Burn Association·Rajiv SoodJohn J Coleman
Oct 1, 1995·Tissue Engineering·G G Gallico, N E O'Connor
Jul 12, 2019·Wound Repair and Regeneration : Official Publication of the Wound Healing Society [and] the European Tissue Repair Society·Cheng Hean LoHeather Cleland
Sep 1, 1996·Annals of Surgery·A M Munster
Jun 2, 2018·Burns and Trauma·Zhe Li, Peter Maitz

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