Abstract
Introduction
The optimal therapy for deep burn wounds is based on the principle of rapid necrectomy and coverage in order to achieve healing that is as scar-free as possible. The available infrastructure and the patient’s condition represent limitations. With enzymatic debridement, selective bedside debridement can now be performed, however the optimal cover after enzymatic debridement has not been elucidated to date. In this study we compare superficial dermal and deep dermal wounds, which are either covered with lactic acid membrane, piscine skin, or split-thickness skin graft. To validate our approach the healed burn wounds were examined for objective (elasticity, water content, sebum, wound healing) and subjective skin quality as part of our standard follow-up care.
Methods
In this study, 12 patients who had received piscine skin, lactic acid membrane, or split-thickness skin graft after enzymatic debridement were retrospectively examined objectively and subjectively for scar quality as part of follow-up care 12 months after the accident. The wound healing process was also documented.
Results
Acceleration of wound healing was observed with the application of piscine skin vs split-thickness skin graft or lactic acid membrane. Skin elasticity was comparable to that of split-thickness skin graft but significantly better than lactic acid membrane. The sebum production in wounds treated with piscine skin was higher compared to lactic acid membrane covered wounds. The water storage capacity in the piscine skin treated wounds was also significantly higher than in lactic acid membrane or split-thickness skin graft treated wounds. Using the POSAS score, an improvement in elasticity, thickness, pigmentation, and relief was shown in piscine skin treated wounds, as well as a reduction in pain and itching, compared to split-thickness skin graft or lactic acid membrane.
Conclusions
The use of intact piscine skin immediately following enzymatic debridement in burn wounds results in faster wound healing and better patient outcomes compared to split-thickness skin graft or lactic acid membrane.
To Glue or Not to Glue? Analysis of Fibrin Glue for Split-thickness Skin Graft Fixation
