Porcine Xenograft and Epidermal Fully Synthetic Skin Substitutes in the Treatment of Partial-Thickness Burns: A Literature Review

Abstract

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.

Successful Treatment Outcomes for Partial Thickness Burns by Innovative Bovine Peritoneum Dressing

“…3 Partial thickness burns with a porcine xenograft are healed by 13.22 ± 2.1 days, and by 13.6 ± 11.1 days in patients with mixed and deep partial thickness burns. 10 This case shows that the patient with incomplete thickness burns was able to fully recover 23 days after xenograft application. It is obvious that such an indicator (23 days) is beyond the average indicators for other grafts.…”

Therapeutic Treatment of 2A Grade Burns with Decellularized Bovine Peritoneum as a Xenograft: Multicenter Randomized Clinical Trial

“…Combined with the average inpatient period in the conditions of the burn center, it comprises 24 days. These results are worse if compared with other xerographs such as Nile tilapia skin, which allows an average of 9.77 ± 0.83 days and 10.56 ± 1.13 days [17] for re-epithelization, and porcine xerograph with re-epithelization at 13.22 ± 2.1 days [18]. A dermal substitute composed of a cross-linked bovine tendon collagen-based dermal matrix linked with glycosaminoglycans (Integra™) is also used for burn treatment.…”

Oxygen, pH, Lactate, and Metabolism—How Old Knowledge and New Insights Might Be Combined for New Wound Treatment

“…Lactate fuels cells by imitating hypoxia under normoxic conditions and encourages metabolic processes such as vasculogenesis and angiogenesis, improving the vascularization and local oxygen tension. Lactate is the key to normalizing the oxygen tension, the acceleration of wound healing, and initiating metabolic processes in fresh wounds and "dead" ulcers, as demonstrated in chronic wounds by Nischwitz et al [115]. A normally vascularized wound after lactate treatment is less prone to infections, which has been demonstrated for pigskin.…”