A clinical comparison of pure knitted silk and a complex synthetic skin substitute for the treatment of partial thickness burns

Background and Objectives: Porcine xenografts have been used successfully in partial thickness burn treatment for many years. Their disappearance from the market led to the search for effective and efficient alternatives. In this article, we examine the synthetic epidermal skin substitute Suprathel® as a substitute in the treatment of partial thickness burns. Materials and Methods: A systematic review following the PRISMA guidelines has been performed. Sixteen Suprathel® and 12 porcine xenograft studies could be included. Advantages and disadvantages between the treatments and the studies’ primary endpoints have been investigated qualitatively and quantitatively. Results: Although Suprathel had a nearly six times larger TBSA in their studies (p < 0.001), it showed a significantly lower necessity for skin grafts (p < 0.001), and we found a significantly lower infection rate (p < 0.001) than in Porcine Xenografts. Nonetheless, no significant differences in the healing time (p = 0.67) and the number of dressing changes until complete wound healing (p = 0.139) could be found. Both products reduced pain to various degrees with the impression of a better performance of Suprathel® on a qualitative level. Porcine xenograft was not recommended for donor sites or coverage of sheet-transplanted keratinocytes, while Suprathel® was used successfully in both indications. Conclusion: The investigated parameters indicate that Suprathel® to be an effective replacement for porcine xenografts with even lower subsequent treatment rates. Suprathel® appears to be usable in an extended range of indications compared to porcine xenograft. Data heterogeneity limited conclusions from the results.

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A Randomized Comparison Study of Lyophilized Nile Tilapia Skin and Silver-Impregnated Sodium Carboxymethylcellulose for the Treatment of Superficial Partial-Thickness Burns

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa099 ◽

2020 ◽

Author(s):

Edmar Maciel Lima Júnior ◽

Manoel Odorico de Moraes Filho ◽

Bruno Almeida Costa ◽

Francisco Vagnaldo Fechine ◽

Marina Becker Sales Rocha ◽

...

Keyword(s):

Pilot Study ◽

Nile Tilapia ◽

Test Group ◽

Skin Substitute ◽

Sodium Carboxymethylcellulose ◽

Open Label ◽

Burn Treatment ◽

Partial Thickness ◽

Patient Reported ◽

Partial Thickness Burns

Abstract Glycerolized Nile tilapia skin (NTS) showed promising results when used for burn treatment in phases II and III randomized controlled trials. This pilot study aims to evaluate the effectiveness of lyophilized NTS (LNTS) as a temporary skin substitute for superficial partial-thickness burns by comparing it with silver-impregnated sodium carboxymethylcellulose dressing. This was a randomized, prospective, open-label, and controlled pilot study conducted in Fortaleza, Brazil, from April 2019 to December 2019. The 24 participants had ≥18 and ≤70 years of age and superficial partial-thickness burns affecting up to 10% of TBSA. Primary outcomes were the number of dressings performed and pain intensity, assessed via the Visual Analogue Scale and the Electronic von Frey. Secondary outcomes were the level of pain-related anxiety, assessed via the Burns Specific Pain Anxiety Scale, and analgesic consumption. In the test group, the number of dressings and the patient-reported pain after dressing-related procedures were lower. Analgesic intake, pain-related anxiety, and both patient-reported and objectively measured pain before dressing-related procedures were similar for the treatment groups. No adverse effects were detected. LNTS shares the same characteristics of an “‘ideal’” wound dressing demonstrated by glycerolized NTS in previous studies. Also, it demonstrated noninferiority for burn management when compared with silver-impregnated sodium carboxymethylcellulose dressing. The safety and efficacy of LNTS demonstrated in this pilot study may allow the development of larger phases II and III RCTs in a near future.

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Use Of Synthetic Skin Substitute (Biobrane) For Plantar Foot Burn

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v4i2.229 ◽

2018 ◽

Vol 4 (2) ◽

pp. 101-104

Author(s):

Johandi F ◽

Feng J ◽

Ruth Lumbun ◽

Chong J ◽

Tan B K ◽

...

Keyword(s):

Length Of Stay ◽

Small Sample Size ◽

Case Series ◽

Small Sample ◽

Skin Substitute ◽

Repeat Surgery ◽

Partial Thickness ◽

Partial Thickness Burn ◽

Singapore General Hospital ◽

Partial Thickness Burns

Background : In Singapore, we experience a unique annual surge of burn cases involving sole of foot during the Hindu fire walking festival. Traditionally, superficial partial-thickness burns of the soles were managed expectantly with regular dressings. We conducted a study to evaluate the effectiveness of an alternative approach of using synthetic skin substitute (Biobrane®). Method : A case series of foot burns admitted October 2016 to the Singapore General Hospital Burns Centre. Burn cases with superficial partial-thickness burn of bilateral sole of foot were included in the study. Exclusion criteria included deep dermal burns and burns that required excision and closure with skin grafting. The patient demographics, time to presentation, medical co-morbidities were analyzed. Outcomes such as length of hospital stay, incidence of infection, need for further surgery, return to pre-injury ambulation status and occupation and cost were studied. Result : A total of 6 partial thickness burns of sole of foot in 3 patients with bilateral foot burns which were treated with Biobrane® were included in the study. Patients were able to return pre-injury functional status- return to work and pre-morbid ambulation status. Neither incidence of wound infections nor any needs for repeat surgery were recorded. However, this group required an increased length of stay and incurred high treatment cost. Conclusion: Biobrane® is a viable adjunct in the management of sole of foot burns. The authors believe there is potential for an improved rate of recovery with Biobrane®. However, the higher cost and length of stay are among its drawbacks. In view of the limitations of our study- case series and small sample size, a prospective and double arm assessment will be required to present definite evidence for synthetic skin substitute in these cases

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