Autologous Skin Cell Suspension Research Articles

P51. Point-of-care Autologous Skin Cell Suspension for the Closure of Full-thickness Defects: Case Series of 40 Patients Treated at an Urban Level 1 Trauma Center

P51. Point-of-care Autologous Skin Cell Suspension for the Closure of Full-thickness Defects: Case Series of 40 Patients Treated at an Urban Level 1 Trauma Center

528 Efficacy of Autologous Skin Cell Suspension in the Closure of Thermal and Non-thermal Full-thickness Wounds

528 Efficacy of Autologous Skin Cell Suspension in the Closure of Thermal and Non-thermal Full-thickness Wounds

611 Comparison of Autologous Skin Cell Suspension to Conventional Surgical Treatment in Burn Patients

611 Comparison of Autologous Skin Cell Suspension to Conventional Surgical Treatment in Burn Patients

806 Autologous Skin Cell Suspension Demonstrates Successful Outcomes in the Treatment of Burn and Wound Sites

806 Autologous Skin Cell Suspension Demonstrates Successful Outcomes in the Treatment of Burn and Wound Sites

135 Evaluation of Autologous Skin Cell Suspension on Re-epithelialization and Repigmentation in Pre-clinical Models

135 Evaluation of Autologous Skin Cell Suspension on Re-epithelialization and Repigmentation in Pre-clinical Models

Comparative results of autologous skin cell suspension combined with a contact layer dressing versus autologous skin cell suspension and a poly-lactic acid dressing in larger total body surface burns

IntroductionContact layer dressing (CLD) is standard after autologous skin cell suspension (ASCS); however, the authors wondered whether a poly-lactic acid dressing (PLAD) results in superior outcomes and cost savings. Material and methodsRetrospective cohort study including greater than 10% total body surface area (TBSA) burns treated with ASCS and either PLAD or CLD. Primary outcomes were infection and length of stay (LOS). Results71 patients (76% male, 24% pediatric, mean age 37 years) were included. Twenty-eight patients (39%) received CLD and 43 (61%) received PLAD. Wound infections were decreased in PLAD (7 vs 32%, p = 0.009). When controlling for area grafted (cm2) and TBSA, logistic regression revealed odds of post-operative infection was 8.1 times higher in CLD (p = 0.015). PLAD required antibiotics for fewer days (mean 0.47 vs 4.39, p = 0.0074) and shorter LOS (mean 17 vs 29 days, p < 0.001). Mean adjusted charges per %TBSA was $18,459 in PLAD vs. $25,397 in CLD (p = 0.0621). ConclusionIn the first analysis of its kind, this study showed polylactic acid dressing combined with autologous skin cell suspension led to a decrease in postoperative infections, length of hospital stay, and total patient charges.

543 - Early repigmentation of stable vitiligo through point-of-care melanocyte transfer using non-cultured autologous skin cell suspension

Abstract Introduction Vitiligo is an acquired depigmenting skin condition characterized by the loss of skin pigmentation, impacting 0.5% to 2% of the global population.1–3 Vitiligo presents as distinct depigmented patches resulting from autoimmune melanocyte destruction. Individuals with visual vitiligo lesions often experience negative body image, diminished self-confidence, discomfort, and overall lower quality of life (QoL).4 While there are medical treatment options available, these can be associated with poor efficacy and low medication compliance.4 Residual lesions after treatment may require surgical intervention which allows for melanocyte transplantation from an area that is pigmented to one that is lacking functional melanocytes. Through a point-of-care device, a non-cultured autologous skin cell suspension (ACSC) can be prepared using a small skin sample; the ASCS contains healthy melanocytes and is immediately applied onto skin treated with ablative laser to aid in the repigmentation of affected areas. Objective The objective of this study was to evaluate the one-time application of ASCS, with a 1:20 donor to treatment site expansion ratio, for the safe and effective repigmentation of stable vitiligo lesions. Methods A randomized, within-subject controlled, central observer-blinded study was conducted to compare the clinical performance of laser ablation, ASCS, and NB-UVB to NB-UVB alone for repigmentation of stable vitiligo lesions in adults. Subjects received NB-UVB phototherapy on both ASCS-treated and controlled lesions as per recommended by the Vitiligo Working Group. Repigmentation of ASCS-treated and control lesions were categorized by a Central Review Committee (CRC) of blinded dermatologists as one of the following: 0%-25%, 26%-50%, 51%-79%, or 80-100%. The primary effectiveness endpoint was defined as the proportion of lesions achieving ≥80% repigmentation for ASCS-treated versus control areas at Week 24. Early regimentation was assessed at Weeks 4 and 12 as a post hoc analysis. Results A significantly higher proportion of the ASCS-treated areas (36.0%, n = 9) compared to control-treated areas (0.0%) attained ≥80% repigmentation at Week 24 (P = 0.012). At Week 4, 30.4% (n = 7/23) of ASCS-treated areas had ≥26% repigmentation compared to 4.3% (n = 1/23) in the control areas. At Week 12, 56.5% (n = 13/23) of ASCS-treated areas had ≥26% repigmentation compared to 21.7% (n = 5/23) in the control areas. At Week 24, 64% (n = 16/25) of ASCS-treated areas had ≥26% repigmentation compared to 28% (n = 7/25) in the control areas. Conclusion A one-time treatment of ASCS, with the addition of NB-UVB, can result in excellent repigmentation results by 24 weeks, with most subjects seeing ≥26% repigmentation as early as 4 to 12 weeks.

Autologous Skin Cell Suspension for Full-Thickness Skin Defect Reconstruction: Current Evidence and Health Economic Expectations.

Despite differing etiologies, acute thermal burn injuries and full-thickness (FT) skin defects are associated with similar therapeutic challenges. When not amenable to primary or secondary closure, the conventional standard of care (SoC) treatment for these wound types is split-thickness skin grafting (STSG). This invasive procedure requires adequate availability of donor skin and is associated with donor site morbidity, high healthcare resource use (HCRU), and costs related to prolonged hospitalization. As such, treatment options that can facilitate effective healing and donor skin sparing have been highly anticipated. The RECELL® Autologous Cell Harvesting Device facilitates preparation of an autologous skin cell suspension (ASCS) for the treatment of acute thermal burns and FT skin defects. In initial clinical trials, the approach showed superior donor skin-sparing benefits and comparable wound healing to SoC STSG among patients with acute thermal burn injuries. These findings led to approval of RECELL for this indication by the US Food and Drug Administration (FDA) in 2018. Subsequent clinical evaluation in non-thermal FT skin wounds showed that RECELL, when used in combination with widely meshed STSG, provides donor skin-sparing advantages and comparable healing outcomes compared with SoC STSG. As a result, the device received FDA approval in June of 2023 for treatment of FT skin defects caused by traumatic avulsion or surgical excision or resection. Given that health economic advantages have been demonstrated for RECELL ± STSG versus STSG alone when used for burn therapy, it is prudent to examine similarities in the burn and FT skin defect treatment pathways to forecast the potential health economic advantages for RECELL when used in FT skin defects. This article discusses the parallels between the two indications, the clinical outcomes reported for RECELL, and the HCRU and cost benefits that may be anticipated with use of the device for non-thermal FT skin defects.

Early Repigmentation of Stable Vitiligo through Point-of-Care Melanocyte Transfer Using Non-Cultured Autologous Skin Cell Suspension

Introduction: Vitiligo is an acquired depigmenting skin condition characterized by the loss of skin pigmentation, impacting 0.5% to 2% of the global population.1,2 Vitiligo presents as distinct depigmented patches resulting from autoimmune melanocyte destruction. Individuals with visual vitiligo lesions often experience negative body image, diminished self-confidence, discomfort, and overall lower quality of life (QoL).3 While there are medical treatment options available, these can be associated with poor efficacy and low medication compliance.4 Residual lesions after treatment may require surgical intervention which allows for melanocyte transplantation from an area that is pigmented to one that is lacking functional melanocytes. Through a point-of-care device, a non-cultured autologous skin cell suspension (ACSC) can be prepared using a small skin sample; the ASCS contains healthy melanocytes and is immediately applied onto skin treated with ablative laser to aid in the repigmentation of affected areas. The objective of this study was to evaluate the one-time application of ASCS, with a 1:20 donor to treatment site expansion ratio, for the safe and effective repigmentation of stable vitiligo lesions. Methods: A randomized, within-subject controlled, central observer-blinded study was conducted to compare the clinical performance of laser ablation, ASCS, and NB-UVB to NB-UVB alone for repigmentation of stable vitiligo lesions in adults. Subjects received NB-UVB phototherapy on both ASCS-treated and controlled lesions as per recommended by the Vitiligo Working Group. Repigmentation of ASCS-treated and control lesions were categorized by a Central Review Committee (CRC) of blinded dermatologists as one of the following: 0%-25%, 26%-50%, 51%-79%, or 80-100%. The primary effectiveness endpoint was defined as the proportion of lesions achieving ≥80% repigmentation for ASCS-treated versus control areas at Week 24. Early regimentation was assessed at Weeks 4 and 12 as a post hoc analysis. Results: A significantly higher proportion of the ASCS-treated areas (36.0%, n = 9) compared to control-treated areas (0.0%) attained ≥80% repigmentation at Week 24 (P = 0.012). At Week 4, 30.4% (n = 7/23) of ASCS-treated areas had ≥26% repigmentation compared to 4.3% (n = 1/23) in the control areas. At Week 12, 56.5% (n = 13/23) of ASCS-treated areas had ≥26% repigmentation compared to 21.7% (n = 5/23) in the control areas. At Week 24, 64% (n = 16/25) of ASCS-treated areas had ≥26% repigmentation compared to 28% (n = 7/25) in the control areas. Conclusion: A one-time treatment of ASCS, with the addition of NB-UVB, can result in excellent repigmentation results by 24 weeks, with most subjects seeing ≥26% repigmentation as early as 4 to 12 weeks.

Treatment of Necrotizing Fasciitis With NovoSorb Biodegradable Temporizing Matrix and RECELL Autologous Skin Cell Suspension: A Case Series.

This case series reviews the management of 2 patients who developed a rare, aggressive soft tissue infection, necrotizing fasciitis treated with a synthetic polyurethane dermal regenerative template, Biodegradable Temporizing Matrix (NovoSorb BTM) in conjunction with an off-label use of RECELL device applying autologous skin cell suspension and a split-thickness skin graft for reconstruction. The clinical relevance describes a non-traditional patient's course of treatment and clinical outcome using BTM and RECELL for necrotizing fasciitis. The 2 patients survived with acceptable outcomes and timely healing despite a high chance of mortality and likely amputation secondary to the extensive surface area and anatomical location of the infection.

Deep palm burn treated with enzymatic debridement followed by autologous skin cell suspension: a case study.

Despite improvements in treatment methods and outcomes, burns remain one of the principal causes of mortality and morbidity worldwide. Burns involving the hands are estimated to occur in >80% of people with burns. Hand burns have also been associated with long-term social, psychological and physical consequences that can impede a patient's full reintegration to the community and decrease their overall quality of life. Clinically, when the trajectory towards complete re-epithelialisation stalls in deep burn wounds of the hand, skin grafting is indicated, but cosmetic problems often remain. A recent publication highlighted common complications for burns involving the hand such as scar disturbances (26%) and scar contractures (14%). Innovative approaches with the potential to reduce the occurrence of complicating scar disturbances and contractures are sought by healthcare providers specialising in burns. This case report describes a novel approach to wound closure using a topical concentrate of proteolytic enzymes followed by the application of an autologous skin cell suspension. This combination was effective in achieving early and complete re-epithelialisation of a deep burn of the palm of a 28-year-old male patient, while potentially affording a favourable impact on hypertrophic scarring or scar contracture.

298 Use of Autologous Skin Cell Suspension Improves Clinical Outcomes and Patient Charges in Large Burns

Abstract Introduction The use of autologous skin cell suspension (ASCS) is an adjunct to the standard of care for definitive wound closure for burn patients. Several published predictive models have indicated theoretical reductions in length of stay (LOS) and hospital costs. There are no studies comparing a single institution’s clinical and surgical results, and patient specific, inflation adjusted, cost/charge data prior to and after utilizing ASCS. Methods A retrospective study was conducted of all patients with &amp;gt;10% TBSA burn from January 2017 to July 2022. The use of ASCS was standardized in January 2019. Demographics, co-morbidities and clinical/surgical outcomes (LOS, wound infections, other infectious complications, square cm [adults] or % TBSA [pediatrics] grafted and re-grafted, number of surgeries, number of reconstructive surgeries as well as use and duration of antibiotics were recorded. Patient specific, annual institutional inflation adjusted charges as a surrogate for cost of care were analyzed. Comparative groups included all patients with &amp;gt;10% TBSA burns treated without ASCS (“Pre”) versus all patients treated with ASCS (“Post”) as well as a post-hoc analysis of patients treated surgically with either split thickness skin graft (“STSG”) versus ASCS, either alone (“A”) or in conjunction with STSG (“A+STSG”). For comparative analysis all patients treated with ASCS patients started in January 2019 were included when a standard approach was created. Statistical analysis including regression modeling was performed. Results 168 met inclusion criteria of which 92 patients were in the “Pre” group (66 treated with STSG and 26 conservatively without surgery) and 76 patients were in the “Post” group (either A [12] or A+STSG [64]). Significant demographic differences were % TBSA and history of hepatic disease (both higher in “Post” group) - see table. Patients in the “Post” group had decreased LOS and LOS/%TBSA, number of surgeries, infectious complications, use of and duration of antibiotics and charges/%TBSA. Sub group analysis of “STSG” versus “A” + “A+STSG” (all patients undergoing surgery) again demonstrated the above findings as well as decreased percentage of TBSA requiring re-grafting (STSG: 10% vs A/A+STSG: 1.4% in adults and STSG: 3.25% vs A/A+STSG: 0.5% in pediatrics) - see table. On average, there was a decrease of $5,340.85/%TBSA in the “A” +”A+STSG” versus the “STSG” group. Conclusions In a single institution,, the addition of ASCS for coverage of burns &amp;gt;10% TBSA compared to SOC resulted in improved clinical outcomes and cost of care (decreased LOS, infectious complications, duration of antibiotic usage and re-grafting rates as well as decreased charges/%TBSA burn). This is the first study to demonstrate actual differences in multiple clinical/surgical outcomes and patient charges. Applicability of Research to Practice The addition of ASCS in the surgical management of burn patients may improve clinical outcomes and lead to decreased cost of care.

561 Three-Year Follow Up Treatment For Major Full-Thickness Burns Using Dermal Biodegradable Substitute and Autologous-Skin-Cell-Suspension

Abstract Introduction Novel techniques and technologies have shown increased survival in large TBSA burns, however, challenges with meaningful quality of life and functional outcome pose a concern. Dermal substitute and skin cell suspensions provide an area of ongoing investigation to reduce morbidity from scars, loss of functionality from contractures, and need for further procedures. This study is a follow up on the use of a dermal substitute along with autologous skin cell suspension (ASCS) with long term physical and mental outcomes as assessed with the Burn Specific Health Scale in two survivors of greater than 90% TBSA full-thickness burns. Methods We report on two 18-year-old patients treated with the use of allograft, dermal substitute, and ASCS with split-thickness skin grafts (STSG) to achieve coverage of &amp;gt;90% burns. Patient 1 initially had full-thickness “leathery” burns, sparing only the plantar and dorsal aspect of the feet and patient 2 had fourth-degree burns in most areas with only the groin and feet spared. The patients’ clinic visits were reviewed and both patients agreed to participate in the Brief Burn Specific Health Scale (BSHS-B) questionnaire three-years post discharge. The survey responses of each patient were separated into their respective BSHS-B health domains and a raw Health-related quality of life (HRQOL) score was calculated for each domain. Results Patient survey responses were categorized into their respective domains: interpersonal relationships, simple abilities, affect, body image, sexuality, hand function, treatment regimens, heat sensitivity, and work. We observed in both patients that the hand function and heat sensitivity domains of the patient’s BSHS-B were the lowest scoring in their survey responses, while the interpersonal relationships and simple abilities were the highest scoring. 15 months post discharge the patients’ bilateral upper extremities had 130° of flexion, 80° of supination, and 80° of pronation with no instability of the elbow. Both patients were continuing to work with physical therapy and were able to ambulate in their own home. Conclusions Appropriate psychosocial management in addition to aggressive targeted surgical management and regular post-discharge clinical follow-ups were noted to have contributed to the improved post-operative outcomes in this patient with extensive burns. The findings reported in this follow-up case series demonstrate the promise of utilizing a dermal substitute and ASCS with STSG in acute surgical management of patients with extensive burns. This follow-up study demonstrates the importance of aggressive physical rehabilitation and psychosocial management in these patients’ post-operative course of recovery. Applicability of Research to Practice The findings reported in this follow-up case series suggest the importance of dermal substitute and ASCS is the enhanced positive psychosocial domains and adequate cosmetic appearance along with enhanced physical healing.

299 Donor Site Reduction with Combined Use of Bromelain Enzymatic Debridement and Autologous Skin Cell Suspension

Abstract Introduction The conventional treatment for deep 2nd and 3rd degree burn injuries has been excision and grafting, which was first described approximately 80 years ago. New techniques and technology in the field of burn surgery that facilitate “minimally invasive” donor site reduction include bromelain enzymatic debridement and autologous skin cell sprays (ASCS). Each of these techniques independently have been shown to decrease the need of autografting and reduce the donor site size. However, the use of both methods together was not possible until recently. The authors hypothesize that bromelain enzymatic debridement plus ASCS will result in donor site reduction compared to conventional excision and grafting. Methods A single institution retrospective review of patients who underwent treatment of deep 2nd and 3rd degree burns was performed. The patients were stratified into those that received conventional excision and autografting (CONTROL group), and those that received bromelain enzymatic debridement with autologous skin cell spray with or without a split thickness skin graft (TREATMENT group). Data collection included demographics, injury characteristics, length of stay (LOS)/%TBSA. Total surface area treated with ASCS, autograft, and donor site size was tabulated. A ratio of donor site to total area treated was calculated and compared to determine relative reduction in donor site size. Data was reported in medians+IQR and comparisons were done with a Mann Whitney test. Results Twenty-eight study patients were included over 18 months, 15 CONTROLS and 13 TREATMENT patients. Burns size was 1789 cm2 (IQR: 450, 2434) and 1463cm2 (IQR: 699, 2740.5) in the CONTROLS and TREATMENT groups, respectively. There were no differences in age and sex. The total area grafted and/or treated with ASCS was 1342 cm2 (IQR: 824, 2535) in the CONTROLS and 1404 cm2 (IQR: 1021.5, 2430.5) in the TREATMENT group (p=0.4354). The donor site area to total treatment area ratio for CONTROLS was 0.273 (IQR:0.18,0.47) while the TREATMENT group was 0.082 (IQR:0.039,0.241) (p=0.013). The O/E ratio for LOS was 1.35 days/%TBSA for the CONTROLS and 1.06 for the TREATMENT group (p= 0.2). No significantly differences were detected in comorbidities between groups. Each group had 1 unplanned readmission but no graft loss. There were no mortalities. Conclusions Bromelain based enzymatic debridement can be successfully utilized with ASCS to perform a “minimally invasive” skin graft. These patients received relatively smaller donor sites and showed a trend for lower LOS. Just as with all surgical therapies, appropriate patient selection and burn characteristics are imperative when utilizing minimally invasive burn surgery. Further larger scale studies are needed to adjust for confounders and determine the individual and synergistic effects of the component novel therapies. Applicability of Research to Practice Donor site reduction improves care paradigms

Analysis of real-world length of stay data and costs associated with use of autologous skin cell suspension for the treatment of small burns in U.S. centers.

Autologous skin cell suspension (ASCS) is a treatment for acute thermal burn injuries associated with significantly lower donor skin requirements than conventional split-thickness skin grafts (STSG). Projections using the BEACON model suggest that among patients with small burns (total body surface area [TBSA]<20%), use of ASCS±STSG leads to a shorter length of stay (LOS) in hospital and cost savings compared with use of STSG alone. This study evaluated whether data from real-world clinical practice corroborate these findings. Electronic medical record data were collected from January 2019 through August 2020 from 500 healthcare facilities in the United States. Adult patients receiving inpatient treatment with ASCS±STSG for small burns were identified and matched to patients receiving STSG using baseline characteristics. LOS was assumed to cost $7554/day and to account for 70% of overall costs. Mean LOS and costs were calculated for the ASCS±STSG and STSG cohorts. A total of 151 ASCS±STSG and 2243 STSG cases were identified; 63.0% of patients were male and the average age was 44.2 years. Sixty-three matches were made between cohorts. LOS was 18.5 days with ASCS±STSG and 20.6 days with STSG (difference: 2.1 days [10.2%]). This difference led to bed cost savings of $15,587.62 per ASCS±STSG patient. Overall cost savings with ASCS±STSG were $22,268.03 per patient. Analysis of real-world data shows that treatment of small burn injuries with ASCS±STSG provides reduced LOS and substantial cost savings compared with STSG, supporting the validity of the BEACON model projections.

A Pilot Randomised Controlled Trial Evaluating a Regenerative Epithelial Suspension for Medium-Size Partial-Thickness Burns in Children: The BRACS Trial

Background: There is little evidence regarding the efficacy of Regenerative Epidermal Suspension (RES™) management for paediatric partial-thickness burns. The Biobrane® RECELL® Autologous skin Cell suspension and Silver dressings (BRACS) Trial evaluated three dressings for the re-epithelialisation of partial-thickness burns in children. Methods: Eligible children (age ≤ 16 years; ≥5% TBSA; ≤48 h of injury) were randomised to silver dressings, RES™/Biobrane® or Biobrane®. The measured outcomes were the time to re-epithelialisation (primary outcome), pain, itch, intervention fidelity, treatment satisfaction, health-related quality of life, health resource utilisation and adverse effects. Results: The median time to re-epithelialisation in days was no different for RES™/Biobrane® at 12 (IQR: 5.6–18.4; n = 7) and slower by two days for Biobrane® at 14 (IQR: 6.3–21.7; n = 7) when compared to silver dressings 12 (IQR: 3.7–20.3; n = 8). Reduced pain, fewer infections, no sepsis, no skin graft, and the lowest impact on health-related quality of life were reported in the RES™/Biobrane® group compared to other groups. Due to the COVID-19 pandemic, recruitment suspension resulted in a smaller cohort than expected and an underpowered study. Conclusions: The pilot trial findings should be interpreted cautiously; however, they indicate that a fully powered randomised controlled trial is warranted to substantiate the role of RES™ for medium to large paediatric partial-thickness burn management.

Treatment of Severe Road Rash with ReCell® Autologous Skin Cell Suspension.

Road rash injuries are often variable in severity, with injuries ranging from simple scrapes to full-thickness burns. Autologous skin cell suspension devices, such as ReCell®, have shown increased promise by creating results comparable to the current standard of care, split-thickness skin grafting with significantly less donor skin required. We present a case of a 29-year-old male with significant road rash after a motorcycle accident at highway speeds, who was successfully treated solely with ReCell application. After surgery, he reported decreased pain with wound care and showed overall wound improvement with no changes in range of motion at 2-week follow-up. This case demonstrates the potential of ReCell as an independent treatment modality for pain and skin injury secondary to severe road rash.

Autologous Skin Cell Suspension in Toxic Epidermal Necrolysis: A Case Series.

Toxic epidermal necrolysis (TEN) is a dermatological process which has lacked both clear pathophysiological definition and efficacious medical treatment. This leads to metabolic dysfunction due to the inability to regulate fluid and electrolytes after the loss of skin. It is a deadly and costly disease which is associated with long lengths of stay and high-mortality rates. The depth of TEN mimics that of a partial-thickness burn. There has been documentation of successful usage of autologous skin cell suspension (ASCS) in TEN. This study expands upon our previous experience using ASCS in TEN to a series of three. Dermatology is consulted for biopsy along with the burn surgery team for wound care, where a Score for TEN is performed for risk stratification. Aggressive operative debridement is performed in the operative suite and a healthy, uninvolved donor site is harvested and processed per standard protocol. Dressings are taken down at postoperative day 4 for evaluation. The average length of stay when compared to historical data in literature is a reduction by 48%. ICU days were reduced by 64%. Cost was reduced by 54%. There was no mortality in our population of three. ASCS is both therapeutically and cost effective at treating TEN. The question of type of dressing and decision to operate is mitigated by this intervention. As an efficacious intervention, it reduces hospital stay, reduces wound cares, speeds healing, and provides a cosmetically acceptable outcome.

Length of Stay and Costs with Autologous Skin Cell Suspension Versus Split-Thickness Skin Grafts: Burn Care Data from US Centers.

IntroductionAutologous skin cell suspension (ASCS) significantly reduces donor skin requirements versus conventional split-thickness skin grafts (STSG) for thermal burn treatment. In analyses using the Burn-medical counter measure Effectiveness Assessment Cost Outcomes Nexus (BEACON) model, ASCS was associated with shorter hospital length of stay (LOS) and cost savings versus STSG. This study hypothesized that daily practice data from the USA would support these findings.MethodsElectronic medical record data from 500 healthcare facilities (January 2019–August 2020) were used to match adult patients who received inpatient burn treatment with ASCS (± STSG) to patients treated with STSG alone on the basis of sex, age, percent total body surface area (TBSA), and comorbidities. Based on BEACON analyses, LOS was assumed to represent 70% of total costs and used as a proxy to assess the data. Mean LOS, costs, and the incremental revenue associated with inpatient capacity changes were calculated.ResultsA total of 151 ASCS and 2443 STSG patients were identified: 63.0% were male and average age was 44.5 years. Eight-one matches were made between cohorts. LOS was 21.7 days with ASCS and 25.0 days with STSG alone (difference 3.3 days [13.2%]). LOS was lower with ASCS than STSG in four of five TBSA intervals. The LOS difference led to hospital bed cost savings of $25,864 per ASCS patient; overall cost savings were $36,949 per patient. Similar cost savings were observed in TBSA groupings < 20% and ≥ 20%. The reduced LOS with ASCS translated into an increased capacity of 2.2 inpatients/bed annually, which increased hospital revenue by $92,283/burn unit bed annually.ConclusionsReal-world data show that ASCS (± STSG) is associated with reduced LOS and cost savings versus STSG alone across all burn sizes, supporting the validity of the BEACON analyses. ASCS use may also increase patient capacity and throughput, leading to increased hospital revenue.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12325-022-02306-y.

Synergistic Use of Novel Technological Advances in Burn Care Significantly Reduces Hospital Length of Stay Below Predicted: A Case Series

Length of stay is an important metric in healthcare systems, primarily because it reflects the cost of care provided. In the United States, as in many countries, inpatient hospital stays are significantly more expensive than outpatient care across all healthcare conditions,1 so earlier discharge and transition to outpatient care is crucial to help control the ever-increasing cost of healthcare. In burn patients, length of stay has traditionally been estimated at 1 day per 1% total body surface area of burn. This estimation was first described in a round table discussion in 1986.2 However, since that time there has been significant evolution in the quality of care available to burn patients, in both the operating room and ICU. The use of new harvesting techniques, synthetic dermal substitution, and autologous epidermal skin cell suspension are allowing large, deep burns to be excised and covered in much quicker time frames than historically were possible. Examples include the skin harvesting and wound debridement device for grafting and excision, biodegradable temporizing matrix as a fully synthetic dermal template, and regenerative epidermal suspension concerning cell harvesting. Although these modalities can all be used separately, we believe that using them in conjunction has allowed us to shorten the length of stay in patients with severe partial and full-thickness burns. We present an initial case series of three patients with anticipated hospital lengths of stay of 54.5, 55, and 51 days, who were ready for discharge in 37, 35, and 43 days, respectively.