658 Early Interventions with Autologous Skin Cell Suspension Leads to Positive Outcomes

Abstract

Abstract Introduction Following initial stabilization, the primary goal of burn care is rapid wound closure to restore the barrier function and mechanical integrity of the skin. Time to wound closure is an important consideration when establishing the treatment plan, with a goal of re-epithelialization by 21 days to reduce the risks of hypertrophic scars (HTS), however, new research suggests that HTS can occur when healing is achieved as early as day 8. Early treatment of deep partial-thickness burns with autologous skin cell suspension (ASCS) was implemented at our burn center to achieve early wound closure and decrease hospital length of stay (LOS). Methods An IRB-approved, retrospective chart review of patients admitted between January 2020 to July 2020 was completed to evaluate the effectiveness of ASCS when applied as an early treatment defined as within 3 days of injury. Burn patients were excluded with delayed presentation >7 days, patients who only received ASCS to donor sites, and patients who died from unrelated comorbidities. Patients were excised to viable tissue. Patients with intact dermis were treated with ASCS. Patients without intact dermis were treated with ASCS and widely meshed autograft. Non-absorbent, small pore dressings were applied to the wound then covered with bismuth-petrolatum dressing, dry gauze, and compression bandage. Patients appropriate for discharge were followed-up in clinic for the first dressing change. Results Twenty-three patients were treated with ASCS utilizing this early intervention approach with 16 patients meeting inclusion criteria. Patients ranged from 15 months to 73 years of age and included 6 females and 10 males. The median total body surface area (TBSA) was 7.3% (range 2-23). Patients were taken for ASCS application between post burn day 0-3 (average 1.5). Average hospital LOS was 2.4 days. Operative dressings were removed between day 7-12 and >90% re-epithelization was noted between day 7-18 (mean 11). The mean LOS/%TBSA was 0.3. No patients required re-operation for closure of their wounds or reconstructive interventions for scarring. Conclusions Early excision of deep partial-thickness burns with application of ASCS allowed for healing to be achieved in a timely fashion. Implementation of an early operative approach to burn care allowed for a decrease in LOS and a decreased overall number of dressing changes.