ISSN:
1524-475X
Source:
Blackwell Publishing Journal Backfiles 1879-2005
Topics:
Medicine
Notes:
Introduction: Early excision and closure is standard for severe burn management. Cadaver skin is generally used as temporary coverage if autograft donor sites are inadequate. However, it is associated with an inherent risk of antigenicity and infection and has a limited shelf life and availability. Use of Integra™, a dermal substitute, is well established for postburn reconstruction, but its efficacy as primary coverage for severe burns it is not well documented. Therefore the aim of the present study was to determine the short- and long-term efficacy of Integra™ as an acute cover.Method: Twenty children with 〉40 total body surface area (TBSA) burn, were randomized to be grafted with Integra™ or with the autograft-allograft technique. Short-term outcome measures such as length of hospital stay, mortality, incidence of infection/sepsis, cardiac, respiratory, and metabolic indexes were compared between and within groups before and after Integra™/graft application. Long-term outcome measures such as number of reconstructive procedures and blinded scar scoring were performed up to 2 years postinjury. Statistical analysis was performed using paired and unpaired t-test. Values are expressed as Mean ± SEM and significance accepted at p 〈 0.05.Results: There were no significant differences between groups, in burn size (Controls 74 ± 4% and Integra™ 70 ± 5%), mortality (Control 30%, Integra™ 40%), length of hospital stay (Control 39 ± 4 days, Integra™ 41 ± 4 days), and metabolic rates. In addition, there was no significant incidence of infection or sepsis in the Integra™ group compared to controls. Long-term follow-up (Integra n = 5, control n = 5) revealed a significantly improved scar, in terms of height, thickness, vascularity, and maturity, in the Integra™ group compared to the control group, at 12 months and 18–24 months postburn, (p 〈 0.01).Conclusion: Integra™ can be safely used for immediate wound coverage in children with severe burns, with better functional and aesthetic outcomes up to 2 years postinjury.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1111/j.1067-1927.2005.130215af.x
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