Abstract
Objective: Pediatric burns are a major source of injury and in the absence of adequate care can lead to lifelong functional loss and disfigurement. While split thickness skin autografts are the current standard of care for deep partial and full-thickness burns, this approach is associated with considerable morbidity. For this reason, alternative skin substitutes such as allografts have gained interest.Approach: In the present study, we present a case series of 30 children with various types of burns treated with dehydrated human amnion chorion membrane (dHACM).Results: We show that treatment with dHACM is associated with an excellent rate of healing comparable to split thickness skin grafts with less rate of hypertrophic scar and contracture.Innovation: Treatment with dHACM is particularly attractive as it consists of many tissue regenerative factors, such as growth factors and immune modulators, thus it will reduce the risk of scaring.Conclusion: While dHACM is associated with an increased upfront cost, treating patients with small to moderate-sized burns with dHACM in their regional centers works to decrease downstream costs such as management of prolonged pain from donor-site morbidity, revisional surgeries from scar and contractures of split thickness grafts, and avoiding the cost of transfer to higher level centers of care. Our findings challenge the current standard of care, suggesting that dHACM provides an alternative to the current use of split thickness skin grafting and is a safe, feasible, and potentially superior substitute for the management of small to moderate total body surface area partial and full-thickness pediatric burns.
Highlights
Burn injuries are a prevalent and devastating cause of unintentional morbidity and mortality in the United States
Pediatric burns are a cause of long-term morbidity and can result in a lifetime of functional and esthetic disfigurement
We present a case series of 30 children who demonstrate the utility of dehydrated human amnion chorion membrane (dHACM) as an efficacious substitute for autografts in the management of complex pediatric burn wounds
Summary
In 2015, burn injuries resulted in 356,000 visits to the emergency departments.[1] The pediatric population (age 1–15) is vulnerable, accounting for 23.5% of total burn cases, second only in prevalence to the adult age group (age 20–59), accounting for 55%.2,3. ADVANCES IN WOUND CARE, VOLUME 9, NUMBER 11 2020 Mary Ann Liebert, Inc
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