A clinical evaluation of Biobrane® and Suprathel® in acute burns and reconstructive surgery

Rahmanian-Schwarz, Afshin; Beiderwieden, Anna; Willkomm, Lina-Marie; Amr, Amro; Schaller, Hans-Eberhard; Lotter, Oliver

doi:10.1016/j.burns.2011.07.010

Cited by 66 publications

(27 citation statements)

References 20 publications

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“…These limitations have thus led to the development of noncellular dermal substitutes, which are most often made up of a polymeric scaffold. Examples include Integra (Integra Life Sciences, Plainsboro, NJ, http://www.integralife.com) and Biobrane (UDL Laboratories, Rockford, IL, http://www.udllabs.com), and although such materials result in improved wound healing over untreated controls [7, 8], they are costly to produce and result in relatively poor cosmetic outcomes.…”

Section: Introductionmentioning

confidence: 99%

Bioprinted Amniotic Fluid-Derived Stem Cells Accelerate Healing of Large Skin Wounds

Skardal

Mack

Kapetanovic

et al. 2012

Stem Cells Translational Medicine

575

416

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Stem cells obtained from amniotic fluid show high proliferative capacity in culture and multilineage differentiation potential. Because of the lack of significant immunogenicity and the ability of the amniotic fluid-derived stem (AFS) cells to modulate the inflammatory response, we investigated whether they could augment wound healing in a mouse model of skin regeneration. We used bioprinting technology to treat full-thickness skin wounds in nu/nu mice. AFS cells and bone marrow-derived mesenchymal stem cells (MSCs) were resuspended in fibrin-collagen gel and “printed” over the wound site. At days 0, 7, and 14, AFS cell- and MSC-driven wound closure and re-epithelialization were significantly greater than closure and re-epithelalization in wounds treated by fibrin-collagen gel only. Histological examination showed increased microvessel density and capillary diameters in the AFS cell-treated wounds compared with the MSC-treated wounds, whereas the skin treated only with gel showed the lowest amount of microvessels. However, tracking of fluorescently labeled AFS ceils and MSCs revealed that the cells remained transiently and did not permanently integrate in the tissue. These observations suggest that the increased wound closure rates and angiogenesis may be due to delivery of secreted trophic factors, rather than direct cell-cell interactions. Accordingly, we performed proteomic analysis, which showed that AFS cells secreted a number of growth factors at concentrations higher than those of MSCs. In parallel, we showed that AFS cell-conditioned media induced endothelial cell migration in vitro. Taken together our results indicate that bioprinting AFS cells could be an effective treatment for large-scale wounds and burns.

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Section: Introductionmentioning

confidence: 99%

Bioprinted Amniotic Fluid-Derived Stem Cells Accelerate Healing of Large Skin Wounds

Skardal

Mack

Kapetanovic

et al. 2012

Stem Cells Translational Medicine

575

416

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“…Therefore, new approaches that permit immediate burn wound stabilization and support functional recovery are necessary. Commercially available hydrogel dressings have advantages in that they are often immunologically inert, regulate fluid exchange from the wound surface, and are available as gels, sheets, and impregnated in ordinary cotton gauze pads 7, 10. For shallow, flat wounds, hydrogel sheets are applied as a primary dressing and remain in place for approximately 4–7 days.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of hydrogels for bio‐printing applications

Murphy

Skardal

Atala

2012

J Biomedical Materials Res

481

367

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In the United States alone, there are approximately 500,000 burn injuries that require medical treatment every year. Limitations of current treatments necessitate the development of new methods that can be applied quicker, result in faster wound regeneration, and yield skin that is cosmetically similar to undamaged skin. The development of new hydrogel biomaterials and bioprinting deposition technologies has provided a platform to address this need. Herein we evaluated characteristics of twelve hydrogels to determine their suitability for bioprinting applications. We chose hydrogels that are either commercially available, or are commonly used for research purposes. We evaluated specific hydrogel properties relevant to bioprinting applications, specifically; gelation time, swelling or contraction, stability, biocompatibility and printability. Further, we described regulatory, commercial and financial aspects of each of the hydrogels. While many of the hydrogels screened may exhibit characteristics suitable for other applications, UV-crosslinked Extracel, a hyaluronic acid-based hydrogel, had many of the desired properties for our bioprinting application. Taken together with commercial availability, shelf life, potential for regulatory approval and ease of use, these materials hold the potential to be further developed into fast and effective wound healing treatments.

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“…In two recent systematic reviews on the treatment of partial thickness burns in children, the mean time to reepithelialization in randomized controlled trials (RCT) that used other (semi)synthetic dressings varied between 7.5 and 23.6 days [1, 17]. In adults, no difference in reepithelialization was found when Suprathel ® was compared to other (semi)synthetic dressings (Biobrane ® [18] and Omiderm ® ) [19] or split-thickness skin graft (STSG) [8] in the treatment of partial thickness burns. In pediatric patients, a short reepithelialization time is important as other studies have shown a low risk of developing hypertrophic scars and contractures in burn wounds that healed within 21 days [20, 21].…”

Section: Discussionmentioning

confidence: 99%

“…In adults, treatment with Suprathel ® has shown a better scar quality compared to STSG in the treatment of partial thickness burns after 90 days post burn [8]. On the other hand, two other studies have shown no difference in hypertrophic scar formation when Suprathel ® was compared to Omiderm ® or Biobrane ® in the treatment of partial thickness burns in adults [18, 19]. We found favorable scar quality in our study after 6 months post burn according to the POSAS scores.…”

Section: Discussionmentioning

confidence: 99%

Usability and effectiveness of Suprathel® in partial thickness burns in children

Rashaan

Krijnen

Allema

et al. 2016

Eur J Trauma Emerg Surg

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PurposeEvaluation of usability and effectiveness of Suprathel® in the treatment of partial thickness burns in children.MethodsA prospective, observational study to evaluate adherence of Suprathel® to the wound bed, reepithelialization time, grafting, wound colonization and infection, pain, dressing changes, length of hospital stay (LOS) and scar formation.ResultsTwenty-one children (median age 2.4 years, range 5 months–14 years) with a median total body surface area (TBSA) of 4 % (range 1–18) were included. Median LOS was 10 days (range 3–20). Median outer layer dressing changes was 3 (range 1–14). Suprathel® was only adherent in wounds debrided with Versajet®. Median reepithelialization time was 13 days (range 7–29). Three patients needed a split skin graft. There were 7 (33 %) patients with wound colonization before application of Suprathel®. This increased to 12 (57 %) patients during treatment. One patient developed a wound infection. Median visual analog scale (VAS) scores for background and procedural pain in patients >7 years were 3.2 (range 2–5) and 3.5 (range 2–5), respectively. In younger patients, median background and procedural COMFORT-B scores were 13.8 (range 10–23) and 14.8 (range 13–23, p = 0.03), respectively. Patient and Observer Scar Assessment Scale (POSAS) scores were favorable after 3 and 6 months post burn.ConclusionsSuprathel® provides potential advantages regarding pain and scar formation, but extensive wound debridement is needed to achieve adequate adherence.

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A clinical evaluation of Biobrane® and Suprathel® in acute burns and reconstructive surgery

Cited by 66 publications

References 20 publications

Bioprinted Amniotic Fluid-Derived Stem Cells Accelerate Healing of Large Skin Wounds

Bioprinted Amniotic Fluid-Derived Stem Cells Accelerate Healing of Large Skin Wounds

Evaluation of hydrogels for bio‐printing applications

Usability and effectiveness of Suprathel® in partial thickness burns in children

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