Abstract
Background and Objectives: Porcine xenografts have been used successfully in partial thickness burn treatment for many years. Their disappearance from the market led to the search for effective and efficient alternatives. In this article, we examine the synthetic epidermal skin substitute Suprathel® as a substitute in the treatment of partial thickness burns. Materials and Methods: A systematic review following the PRISMA guidelines has been performed. Sixteen Suprathel® and 12 porcine xenograft studies could be included. Advantages and disadvantages between the treatments and the studies’ primary endpoints have been investigated qualitatively and quantitatively. Results: Although Suprathel had a nearly six times larger TBSA in their studies (p < 0.001), it showed a significantly lower necessity for skin grafts (p < 0.001), and we found a significantly lower infection rate (p < 0.001) than in Porcine Xenografts. Nonetheless, no significant differences in the healing time (p = 0.67) and the number of dressing changes until complete wound healing (p = 0.139) could be found. Both products reduced pain to various degrees with the impression of a better performance of Suprathel® on a qualitative level. Porcine xenograft was not recommended for donor sites or coverage of sheet-transplanted keratinocytes, while Suprathel® was used successfully in both indications. Conclusion: The investigated parameters indicate that Suprathel® to be an effective replacement for porcine xenografts with even lower subsequent treatment rates. Suprathel® appears to be usable in an extended range of indications compared to porcine xenograft. Data heterogeneity limited conclusions from the results.
Highlights
Contemporary burn care aims at rapid closure of open wounds, either temporarily or permanently
When covering freshly harvested keratinocytes after seeding and culturing or precultured keratinocytes, Porcine xenograft (PX) did not adhere to the keratinocytes and, did not survive the first week [46]
Similar results were found in a retrospective study of 103 patients with keratinocytes applied to deep partial-thickness burns and covered with ST [48]
Summary
Contemporary burn care aims at rapid closure of open wounds, either temporarily or permanently. Ltd., Tokyo, Japan), and Suprathel® (ST) (Polymedics Innovations GmbH, Denkendorf, Germany) as epidermal skin substitutes, have been used for the closure of partial-thickness wounds The requirements of these products include safety, ease of application, a short healing time, effectiveness, hypo- allergenicity, and non-oncogenicity, while being able to be stored and cost-effective. Porcine xenografts have been used successfully in partial thickness burn treatment for many years Their disappearance from the market led to the search for effective and efficient alternatives. No significant differences in the healing time (p = 0.67) and the number of dressing changes until complete wound healing (p = 0.139) could be found Both products reduced pain to various degrees with the impression of a better performance of Suprathel® on a qualitative level.
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