Cargando…

507 Earlier Graft Takedown Using Autologous Keratinocyte Suspension in Conjunction with Split Thickness Skin Grafting for the Treatment of Deep 2nd and 3rd Degree Burns

INTRODUCTION: Autologous split-thickness skin grafts (STSG) have been the gold standard concerning treatment of both full and partial thickness burns. However, new treatments are emerging such as spray-on autologous keratinocyte suspensions (AKS). AKS is composed of a patient’s own keratinocytes, fi...

Descripción completa

Detalles Bibliográficos
Autores principales: Credo, Roald, Brown, Elizabeth, Dhaiti, Cris, Pang, Alan, Raghuram, Akshay, Bharadia, Deepak, Griswold, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10185248/
http://dx.doi.org/10.1093/jbcr/irad045.104
_version_ 1785042313850912768
author Credo, Roald
Brown, Elizabeth
Dhaiti, Cris
Pang, Alan
Raghuram, Akshay
Bharadia, Deepak
Griswold, John
author_facet Credo, Roald
Brown, Elizabeth
Dhaiti, Cris
Pang, Alan
Raghuram, Akshay
Bharadia, Deepak
Griswold, John
author_sort Credo, Roald
collection PubMed
description INTRODUCTION: Autologous split-thickness skin grafts (STSG) have been the gold standard concerning treatment of both full and partial thickness burns. However, new treatments are emerging such as spray-on autologous keratinocyte suspensions (AKS). AKS is composed of a patient’s own keratinocytes, fibroblasts, and melanocytes. STSG in conjunction with AKS has showed promising results for the treatment of deep partial and full thickness burns. The standard graft takedown with STSG has historically been on postoperative day (POD) 6. Once graft take down occurs, occupational therapy can begin along with cessation of continuous splinting leading to more convenience and comfortability for the patient. With AKS, we propose that faster wound healing allows graft take down to occur earlier on POD 4. METHODS: A retrospective chart review was conducted at TTUHSC’s UMC Burn Center looking at patients that underwent STSG with AKS for the treatment of their burn. Patients were divided based on graft takedown on POD 4 or 6. Factors such as time to complete wound closure and postoperative complications were analyzed. RESULTS: The average age and total burn surface area in both groups was 43 years old and 28%. In the POD 4 group (n=10) the average time to healing was 2 months while the POD 6 group (n=21) had an average healing time of 3.1 months. Graft take and percentage of patients with changes in postoperative mobility and hypertrophic scarring were the same across both groups (98%, 30%, and 50%, respectively). CONCLUSIONS: While time to healing was slightly different, there was not a statistically significant difference between the two groups. From this study we can conclude that graft take down can occur earlier in patients treated with STSG in conjunction with AKS. This allows for earlier therapeutic intervention and more convenience for the patient. APPLICABILITY OF RESEARCH TO PRACTICE: • Graft takedown can occur earlier on postoperative day 4 instead of 6 in patients treated with split-thickness skin grafting in conjunction with autologous keratinocyte suspension. • Earlier graft takedown allows for earlier occupational therapy and reduces the need for extensive splinting which can be uncomfortable for the patient. • Graft takedown can occur earlier in those treated with split-thickness skin grafting in conjunction with autologous keratinocyte suspension due to the rapid healing the suspension offers.
format Online
Article
Text
id pubmed-10185248
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-101852482023-05-16 507 Earlier Graft Takedown Using Autologous Keratinocyte Suspension in Conjunction with Split Thickness Skin Grafting for the Treatment of Deep 2nd and 3rd Degree Burns Credo, Roald Brown, Elizabeth Dhaiti, Cris Pang, Alan Raghuram, Akshay Bharadia, Deepak Griswold, John J Burn Care Res R-121 Clinical Sciences: Critical Care 1 INTRODUCTION: Autologous split-thickness skin grafts (STSG) have been the gold standard concerning treatment of both full and partial thickness burns. However, new treatments are emerging such as spray-on autologous keratinocyte suspensions (AKS). AKS is composed of a patient’s own keratinocytes, fibroblasts, and melanocytes. STSG in conjunction with AKS has showed promising results for the treatment of deep partial and full thickness burns. The standard graft takedown with STSG has historically been on postoperative day (POD) 6. Once graft take down occurs, occupational therapy can begin along with cessation of continuous splinting leading to more convenience and comfortability for the patient. With AKS, we propose that faster wound healing allows graft take down to occur earlier on POD 4. METHODS: A retrospective chart review was conducted at TTUHSC’s UMC Burn Center looking at patients that underwent STSG with AKS for the treatment of their burn. Patients were divided based on graft takedown on POD 4 or 6. Factors such as time to complete wound closure and postoperative complications were analyzed. RESULTS: The average age and total burn surface area in both groups was 43 years old and 28%. In the POD 4 group (n=10) the average time to healing was 2 months while the POD 6 group (n=21) had an average healing time of 3.1 months. Graft take and percentage of patients with changes in postoperative mobility and hypertrophic scarring were the same across both groups (98%, 30%, and 50%, respectively). CONCLUSIONS: While time to healing was slightly different, there was not a statistically significant difference between the two groups. From this study we can conclude that graft take down can occur earlier in patients treated with STSG in conjunction with AKS. This allows for earlier therapeutic intervention and more convenience for the patient. APPLICABILITY OF RESEARCH TO PRACTICE: • Graft takedown can occur earlier on postoperative day 4 instead of 6 in patients treated with split-thickness skin grafting in conjunction with autologous keratinocyte suspension. • Earlier graft takedown allows for earlier occupational therapy and reduces the need for extensive splinting which can be uncomfortable for the patient. • Graft takedown can occur earlier in those treated with split-thickness skin grafting in conjunction with autologous keratinocyte suspension due to the rapid healing the suspension offers. Oxford University Press 2023-05-15 /pmc/articles/PMC10185248/ http://dx.doi.org/10.1093/jbcr/irad045.104 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the American Burn Association. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle R-121 Clinical Sciences: Critical Care 1
Credo, Roald
Brown, Elizabeth
Dhaiti, Cris
Pang, Alan
Raghuram, Akshay
Bharadia, Deepak
Griswold, John
507 Earlier Graft Takedown Using Autologous Keratinocyte Suspension in Conjunction with Split Thickness Skin Grafting for the Treatment of Deep 2nd and 3rd Degree Burns
title 507 Earlier Graft Takedown Using Autologous Keratinocyte Suspension in Conjunction with Split Thickness Skin Grafting for the Treatment of Deep 2nd and 3rd Degree Burns
title_full 507 Earlier Graft Takedown Using Autologous Keratinocyte Suspension in Conjunction with Split Thickness Skin Grafting for the Treatment of Deep 2nd and 3rd Degree Burns
title_fullStr 507 Earlier Graft Takedown Using Autologous Keratinocyte Suspension in Conjunction with Split Thickness Skin Grafting for the Treatment of Deep 2nd and 3rd Degree Burns
title_full_unstemmed 507 Earlier Graft Takedown Using Autologous Keratinocyte Suspension in Conjunction with Split Thickness Skin Grafting for the Treatment of Deep 2nd and 3rd Degree Burns
title_short 507 Earlier Graft Takedown Using Autologous Keratinocyte Suspension in Conjunction with Split Thickness Skin Grafting for the Treatment of Deep 2nd and 3rd Degree Burns
title_sort 507 earlier graft takedown using autologous keratinocyte suspension in conjunction with split thickness skin grafting for the treatment of deep 2nd and 3rd degree burns
topic R-121 Clinical Sciences: Critical Care 1
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10185248/
http://dx.doi.org/10.1093/jbcr/irad045.104
work_keys_str_mv AT credoroald 507earliergrafttakedownusingautologouskeratinocytesuspensioninconjunctionwithsplitthicknessskingraftingforthetreatmentofdeep2ndand3rddegreeburns
AT brownelizabeth 507earliergrafttakedownusingautologouskeratinocytesuspensioninconjunctionwithsplitthicknessskingraftingforthetreatmentofdeep2ndand3rddegreeburns
AT dhaiticris 507earliergrafttakedownusingautologouskeratinocytesuspensioninconjunctionwithsplitthicknessskingraftingforthetreatmentofdeep2ndand3rddegreeburns
AT pangalan 507earliergrafttakedownusingautologouskeratinocytesuspensioninconjunctionwithsplitthicknessskingraftingforthetreatmentofdeep2ndand3rddegreeburns
AT raghuramakshay 507earliergrafttakedownusingautologouskeratinocytesuspensioninconjunctionwithsplitthicknessskingraftingforthetreatmentofdeep2ndand3rddegreeburns
AT bharadiadeepak 507earliergrafttakedownusingautologouskeratinocytesuspensioninconjunctionwithsplitthicknessskingraftingforthetreatmentofdeep2ndand3rddegreeburns
AT griswoldjohn 507earliergrafttakedownusingautologouskeratinocytesuspensioninconjunctionwithsplitthicknessskingraftingforthetreatmentofdeep2ndand3rddegreeburns