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Area of Science:

  • Regenerative Medicine
  • Burn Surgery
  • Wound Healing

Background:

  • Noncultured autologous skin cell suspensions (ASCS) offer an alternative to split-thickness autologous grafts (STSG) for burn wound coverage, potentially reducing donor site morbidity.
  • ASCS are particularly advantageous for patients with large total body surface area (TBSA) burns due to reduced donor graft requirements.
  • The cost-effectiveness of ASCS for extensive burns remains a consideration, necessitating an evaluation of operative efficiency.

Purpose of the Study:

  • To compare the operative efficiency of ASCS versus STSG in terms of wound coverage area per operative minute.
  • To determine if ASCS utilization decreases operative time for definitive coverage of large burn wounds, potentially offsetting unit costs.
  • To evaluate the hypothesis that ASCS leads to faster definitive wound coverage compared to STSG.

Main Methods:

  • A case-control study comparing ASCS and STSG surgical encounters in adult burn patients.
  • Patients were matched based on total burn surface area, anatomic location, burn etiology, age, and sex.
  • Data on demographics, burn characteristics, and operative details were extracted from electronic medical records.

Main Results:

  • Fifty-one ASCS surgeries were matched with 51 STSG surgeries; groups were similar in demographics, hospital stay, and complications.
  • Significantly greater wound areas were treated with ASCS (2714 ± 1378 cm²) compared to STSG (1555 ± 1209 cm²; P < 0.0001).
  • Operative efficiency was higher with ASCS, treating more wound area per minute (34.5 ± 25.4 cm²/min) than STSG (20.1 ± 10.9 cm²/min; P = 0.001).

Conclusions:

  • ASCS demonstrated superior operative efficiency in burn wound coverage compared to STSG.
  • The use of ASCS resulted in significantly more wound area treated per minute.
  • ASCS offers comparable hospital length of stay and complication profiles, suggesting potential cost-effectiveness for large TBSA burns.