Actual Strategies in the Treatment of Severe Burns - Considering Modern Skin Substitutes

Abstract

Early wound closure enables a better prognosis with regard to survival and outcome in severe burn injuries. Even so, the treatment of extended 2nd degree thermal traumas is well discussed. A conservative procedure with daily changes of dressings and application of topical antimicrobial creams is uncomfortable for patients and staff. In addition, there is a higher risk of severe infection. Meanwhile, early debridement and temporary wound coverage is established as state of the art also in 2nd degree burns. Many biological and textile materials are already in use. The newly designed resorbable polylactide-membrane Suprathel® seems to be a good alternative material. We have proved that Suprathel® significantly reduces pain. The handling of Suprathel® is very easy. This retrospective study of our patients with severe thermal injuries shows that primarily the majority of burn victims were treated with Suprathel®. Only few patients required an additional grafting even in cases with extended burn areas. The frequency of grafting procedures could be reduced considerably. But also patients with extended 3rd degree burn areas requiring an early skin grafting had a benefit from the application of Suprathel® on donor sites and all tangential necrotic areas. Encouraged by this success, we established a new two-step concept for the treatment of severe thermal injuries. This strategy seems to be suitable also for burn centres with low financial resources, because expensive tissue engineering therapies are reduced to a minimum by this concept.