Treatment of burn injuries has developed over the past few years with the development of enzymatic debridement and new types of skin replacement materials beyond primary surgical therapy providing complex personalized therapy concepts with the goal of preserving and replacing the dermal layer of the skin.The aim of our study was to develop an individualized treatment algorithm for mixed depth burn wound and to evaluate the outcome of an individualized combined treatment of mixed depth burn wounds with an enzymatic debridement and decellularized fish skin.A total of 18 Patient treated could be analyzed with a mean age of 34.8 years and a mean follow-up of 447,6 days. The mean total burn surface area was 12.3%. All patients received an enzymatic debridement and an average area of 247.2 square centimeters decellularized fish skin. Days until complete epithelization was 49,4 ± 25,79. No Patient developed a scar contracture or a keloid. The POSAS Observer Scale showed an overall impression average of 2,2 ± 0,83. The POSAS patient scale showed an overall impression average 2 ± 0,7. The Vancouver Scar Scale showed an average score of 1,89 ± 1,45. In conclusion, a combined treatment of enzymatic debridement and decellularized fish skin, polylactide membrane or split skin grafts allows a more individualized therapy for mixed depth burn wounds. Fish skin was found to provide a satisfying result regarding the overall outcome of the developed scar tissue and could lead to a reduction of the area needed to be autologous transplanted.
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