title: A critical evaluation of the use of Biobrane as a biologic skin substitute: a versatile tool for the plastic and reconstructive surgeon.
abstract: BACKGROUND
  Biobrane and Biobrane-L are becoming increasingly popular in the management of superficial and moderate-depth partial-thickness burns, particularly in pediatric patients. When used appropriately, they have been shown to reduce pain levels, healing time, inpatient stay, and nursing requirements when compared with traditional dressings. In this manuscript, we provide a critical evaluation of the evidence base for the varied uses of Biobrane within the field of plastic and reconstructive surgery.
  
  
  METHODS
  We present a comprehensive review of MEDLINE-cited articles, the proceedings of national meetings, relevant books, and information from the suppliers to provide the reconstructive surgeon with an evidence base for the use of Biobrane. We also take this opportunity to discuss religious and ethical issues and the complications of Biobrane application.
  
  
  CONCLUSIONS
  Biobrane is a versatile biosynthetic wound dressing. There is good evidence (Grade A) to support the use of Biobrane in the management of burns, particularly in partial-thickness burns in children. Biobrane also has many potential uses as a dressing outside the burns unit of which we feel reconstructive surgeons should be aware. Conditions resulting in disruption of the epidermis such as toxic epidermal necrolysis (TEN) and paraneoplastic pemphigus have been managed successfully using Biobrane (Grade B). Biobrane has also been successfully used following dermabrasion, skin-graft harvesting, and laser resurfacing (Grades B to C). Temporary coverage with Biobrane has been successfully used in individuals with chronic wounds such as open sternotomy sites and venous ulcers (Grades B to C). Biobrane has a wealth of potential uses outside its traditional remit; however, further prospective clinical trials are warranted if these new applications are to become more widely accepted.
authors.affiliation: Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Morriston, UK. iainwhitaker@fastmail.fm
authors.forename: Iain S
authors.initials: IS
authors.lastname: Whitaker
authors.forename: Simon
authors.initials: S
authors.lastname: Prowse
authors.forename: Tom S
authors.initials: TS
authors.lastname: Potokar
mesh_terms: D002056:Burns / Q000628:therapy*; D020099:Coated Materials, Biocompatible / Q000191:economics / Q000592:standards*; D003362:Cost-Benefit Analysis; D006801:Humans; D012067:Religion; D017768:Skin, Artificial; D013518:Surgery, Plastic / Q000191:economics* / Q000379:methods*; D013997:Time Factors
chemical_list: C042816:Biobrane; D020099:Coated Materials, Biocompatible