Lessons Learned From Two Survivors of Greater Than 90% TBSA Full-Thickness Burn Injuries Using NovoSorb Biodegradable Temporizing Matrix™ and Autologous Skin Cell Suspension, RECELL™: A Case Series

Malkoc, Aldin; Wong, David T.

doi:10.1093/jbcr/iraa176

Cited by 7 publications

(4 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Advantages of this innovative technique included point of care preparation in the OR, short learning curve for the surgical team, in vivo confluence of the grafted keratinocytes, simplified dressing and wound care, early patient mobilization, and significantly decreased cost ($7500 per 1920 cm 2 application, or $3.9/cm 2 ). Multiple refinements and applications have been reported in abundant cases series since then, [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] including the use of ASCS in pediatric patients, the utility of ASCS in wounds other than burns, the efficacy of ASCS in FT defects, and success of ASCS when used with other technologies, such as tissue glue and negative pressure wound therapy.…”

Section: Discussionmentioning

confidence: 99%

Benefits of Aerosolized, Point-of-care, Autologous Skin Cell Suspension (ASCS) for the Closure of full Thickness Wounds from Thermal and Non-Thermal Causes

Hultman,

Adams,

Rogers

et al. 2024

Annals of Surgery

View full text Add to dashboard Cite

Objective: To determine the utility of Autologous Skin Cell Suspension (ASCS) in closing full-thickness (FT) defects from injury and infection. Summary Background Data: Although ASCS has documented success in closing partial-thickness burns, far less is known about the efficacy of ASCS in FT defects. Methods: Fifty consecutive patients with FT defects (burn 17, necrotizing infection 13, crush 7, degloving 5, other 8) underwent closure with the bilayer technique of 3:1 widely-meshed, thin, split-thickness skin graft and 80:1 expanded ASCS. End points were limb salvage rate, donor site reduction, operative and hospital throughput, incidence of complications, and re-epithelialization by 4, 8, and 12 weeks. Results: Definitive wound closure was achieved in 76%, 94%, and 98% of patients, at 4, 8, and 12 weeks, respectively. Limb salvage occurred in 42/43 patients (10 upper, 33 lower extremities). Mean area grafted was 435 cm2; donor site size was 212 cm2, representing a potential reduction of 50%. Mean surgical time was 71 minutes; total OR time was 124 minutes. Mean length-of-stay was 26.4 days; time from grafting to discharge was 11.2 days. 4/50 patients (8%) required 6 reoperations for bleeding (1), breakdown (4), and amputation (1). 4/50 patients (8%) developed hypertrophic scarring, which responded to silicone sheeting (2) and laser resurfacing (2). Mean follow-up was 92.7 days. Conclusion: When used for closure of FT wounds, point-of-care ASCS is effective and safe. Benefits include rapid re-epithelialization, high rate of limb salvage, reduction of donor site size and morbidity, and low incidence of hypertrophic scarring.

show abstract

Section: Discussionmentioning

confidence: 99%

Benefits of Aerosolized, Point-of-care, Autologous Skin Cell Suspension (ASCS) for the Closure of full Thickness Wounds from Thermal and Non-Thermal Causes

Hultman,

Adams,

Rogers

et al. 2024

Annals of Surgery

View full text Add to dashboard Cite

show abstract

“…Advancements at burn facilities have improved mortality rates in patients with greater than 30% TBSA [ 19 ]. Patients with FT burns pose significant challenges including infection, dermal coverage, and management of medical comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Development of Early Abdominal Compartment Syndrome Leading to Emergent Decompressive Laparotomy in Full-Thickness Burn Injury

et al. 2022

Self Cite

View full text Add to dashboard Cite

Burn injuries carry an increased risk of intra-abdominal hypertension and are an independent risk factor for abdominal compartment syndrome (ACS). ACS is most commonly due to large volume resuscitation. The added concern of ACS can complicate resuscitative efforts. Early monitoring for ACS (intra-abdominal pressure > 20 mm Hg with associated new-onset organ dysfunction) and performing prudent decompressive laparotomies are important factors to keep in mind when treating large surface area burn patients. This case report describes the hospitalization of a 60-year-old male who presented with 45% fullthickness (FT) total body surface area (TBSA) and inhalation injury. On arrival to the emergency department (ED), he had received a total of 6 L of intravenous lactate Ringers, and vasopressors were initiated due to hypotension. During the tertiary examination it was noted that there was increased difficulty ventilating the patient, and his abdomen was becoming increasingly distended and tense. His intra-abdominal pressure was measured in the ED and found to be elevated at 32 mm Hg. The findings were suggestive of ACS and a decompressive laparotomy was performed in the ED. Upon entering the abdominal cavity, the abdominal contents extruded through the incision and diffuse venous congestion and gastric distention were noted. Items commonly found in operating rooms (Top-Draper ® warmer drape, Kerlix rolls, Jackson-Pratt suction drains, and 3M ® Ioban sterile antimicrobial incise drape) were utilized to maintain an open abdomen where abdominal contents could easily be observed and to prevent delay in performing a decompressive laparotomy. Here we describe a patient with 45% FT TBSA and inhalation injuries requiring an emergent decompressive laparotomy for ACS after only 6 L of lactate Ringers were administered. This highlights the importance of early monitor-ing for ACS and the ease of performing a decompressive laparotomy with commonly found items in the ED and operating rooms.

show abstract

“…Clinical results document significant improvement in cosmetic appearance and mitigated wound contraction. Specific to severe burns, the BTM serves as a financially reasonable option for large surface area coverage that adequately prevents fluid loss and is less sensitive to infection than other dermal substitutes 70 . While more investigation is still required, these initial reports of the NovoSorb® BTM demonstrate its efficacy as a biodegradable PU scaffold for tissue regeneration.…”

Section: Clinical Applications Of Biodegradable Pu Scaffoldsmentioning

confidence: 99%

Biodegradable polyurethane scaffolds in regenerative medicine: Clinical translation review

Pedersen

Kim

Wagner

2022

J Biomedical Materials Res

View full text Add to dashboard Cite

Early explorations of tissue engineering and regenerative medicine concepts commonly utilized simple polyesters such as polyglycolide, polylactide, and their copolymers as scaffolds. These biomaterials were deemed clinically acceptable, readily accessible, and provided processability and a generally known biological response. With experience and refinement of approaches, greater control of material properties and integrated bioactivity has received emphasis and a broadened palette of synthetic biomaterials has been employed. Biodegradable polyurethanes (PUs) have emerged as an attractive option for synthetic scaffolds in a variety of tissue applications because of their flexibility in molecular design and ability to fulfill mechanical property objectives, particularly in soft tissue applications. Biodegradable PUs are highly customizable based on their composition and processability to impart tailored mechanical and degradation behavior. Additionally, bioactive agents can be readily incorporated into these scaffolds to drive a desired biological response. Enthusiasm for biodegradable PU scaffolds has soared in recent years, leading to rapid growth in the literature documenting novel PU chemistries, scaffold designs, mechanical properties, and aspects of biocompatibility. Despite the enthusiasm in the field, there are still few examples of biodegradable PU scaffolds that have achieved regulatory approval and routine clinical use. However, there is a growing literature where biodegradable PU scaffolds are being specifically developed for a wide range of pathologies and where relevant pre‐clinical models are being employed. The purpose of this review is first to highlight examples of clinically used biodegradable PU scaffolds, and then to summarize the growing body of reports on pre‐clinical applications of biodegradable PU scaffolds.

show abstract

Lessons Learned From Two Survivors of Greater Than 90% TBSA Full-Thickness Burn Injuries Using NovoSorb Biodegradable Temporizing Matrix™ and Autologous Skin Cell Suspension, RECELL™: A Case Series

Cited by 7 publications

References 6 publications

Benefits of Aerosolized, Point-of-care, Autologous Skin Cell Suspension (ASCS) for the Closure of full Thickness Wounds from Thermal and Non-Thermal Causes

Benefits of Aerosolized, Point-of-care, Autologous Skin Cell Suspension (ASCS) for the Closure of full Thickness Wounds from Thermal and Non-Thermal Causes

Development of Early Abdominal Compartment Syndrome Leading to Emergent Decompressive Laparotomy in Full-Thickness Burn Injury

Biodegradable polyurethane scaffolds in regenerative medicine: Clinical translation review

Contact Info

Product

Resources

About