111 10 Years of Clinical Experience Using Point of Care Non Cultured Autologous Skin Cell Suspension

Abstract

Time to healing is a key driver of scar outcome in the repair of skin post burn injury. Autologous skin cell suspension has facilitated early intervention or wound healing in isolation in partial thickness injuries and in combination with traditional techniques in deeper injuries with limited donor sites. The aim of the presentation is the analysis of the impact of the introduction of cell based therapies into a clinical model of care in a health system providing burn care to a population of 2.5 million The data captured prospectively from the point of injury to the 1 year follow up was analysed retrospectively. A comprehensive data base has been well established to include the injury details, interventions and an outcome battery considering functional psychological and aesthetic outcomes at multiple time points. The data was subject to a data hack process followed by in-depth data analytics using 1.2 million rows of data points. In a 10 year period the cell based therapy technique was used in 3500 cases, 9% scar revision, 90% acute burn injury and 1% miscellaneous wounds. Of the cases requiring surgical intervention 12% received SSG alone, 48% SSG and cells and 40% cells alone. The use of cell therapies was associated with a reduction in the number of surgical procedures, with earlier intervention and reduction in time to healing and length of stay. When using a cumulative outcome index the intervention within 1 week of injury was associated with significant improvement at 3 months which was maintained at 1 year post injury. Cell based therapies are associated with earlier intervention and associated reduction in scarring and measurable improvement in outcomes. Since evolving from cultured epithelial autograft sheets to suspension in 1995 then onto non cultured skin cell suspension in 1998, the use of skin cell therapies has become integrated into the standard of care. The results need to be taken in the context of a comprehensive model of care which focuses on every intervention from the time of injury to optimise marginal gains along the clinical pathway.