The use of a bioactive skin substitute decreases length of stay for pediatric burn patients.
BACKGROUND
To optimize burn care for children, the authors introduced a protocol incorporating the use of a bioactive skin substitute, TransCyte (Advanced Tissue Sciences, La Jolla, CA). This study was designed to determine whether this management plan was safe, efficacious, and decreased hospital inpatient length of stay (LOS) compared with conventional burn management in children.


METHODS
All pediatric burns greater than 7% total body surface area (TBSA) that occurred after October 1999 underwent wound closure with TransCyte (n = 20). These cases were compared with the previous 20 consecutive burn cases greater than 7% TBSA that received standard therapy. Standard therapy consisted of application of antimicrobial ointments and hydrodebridement. The following information was obtained: burn mechanism, age, size of burn, requirement of autograft, and LOS. Data were analyzed using the student's t test.


RESULTS
Data for age, percent TBSA burn and LOS are reported as means +/- SEM. The children who received standard therapy were 2.99 +/- 0.7 years compared with those receiving TransCyte were 3.1 +/- 0.8 years. There was no difference between the treatment groups with regard to percent TBSA burn: standard therapy, 14.3 +/- 1.4% TBSA versus TransCyte, 12.7 +/- 1.3% TBSA. There was no difference in the type of burns in each group, the majority were liquid scald type, 70% in the standard therapy group versus 90% in the TransCyte group. Only 1 child in the TransCyte group required autografting (5%) compared with 7 children in the standard therapy group (35%). Children treated with TransCyte had a statistically 6 significant decreaed LOS compared with those receiving standard therapy, 5.9 +/- 0.9 days versus 13.8 +/- 2.2 days, respectively (P =.002).


CONCLUSIONS
This is the first study using TransCyte in children. The authors found that this protocol of burn care was safe, effective, and significantly reduced the LOS. This new approach to pediatric burn care is effective and improves the quality of care for children with burns.
Lukish
J R
JR
Department of Pediatric Surgery, Children's National Medical Center, Washington, DC 20010, USA.
Eichelberger
M R
MR
Newman
K D
KD
Pao
M
M
Nobuhara
K
K
Keating
M
M
Golonka
N
N
Pratsch
G
G
Misra
V
V
Valladares
E
E
Johnson
P
P
Gilbert
J C
JC
Powell
D M
DM
Hartman
G E
GE
D002053:Burn Units / Q000706:statistics & numerical data; D002056:Burns / Q000175:diagnosis / Q000601:surgery*; D002675:Child, Preschool; D004219:District of Columbia; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016038:Skin Transplantation / Q000379:methods*; D017768:Skin, Artificial; D014182:Transplantation, Autologous; D014945:Wound Healing / Q000502:physiology