Use of an autologous bioengineered composite skin in extensive burns: Clinical and functional outcomes. A multicentric study.
OBJECTIVE
We report clinical and functional outcomes obtained after application of an autologous bioengineered composite skin (ABCS) produced in a single Spanish tissue-engineering unit.


METHODS
Twenty-five burned patients treated with ABCS from 1999 to 2007 in five burn centres were included in the study. Mean age was 29 years (SD 11), with mean total body surface area (TBSA) burned being 74% (SD 17) and mean full-thickness injury of 61% (SD 19) of TBSA.


RESULTS
The mean area initially engrafted with ABCS was 24% (SD 13) of TBSA, with a final take of 49% (SD 30, range 0-100%). ABCS achieved permanent coverage of a mean of 11% (SD 8) of TBSA. In subset analyses, lack of pre- and post-application wound bed infection and lack of serious acute systemic complications at the time of engraftment were significantly associated with better ABCS take.


CONCLUSIONS
Final take obtained with ABCS could be improved with the use of non-cytotoxic topical antibiotics following engraftment. The use of plasma to prepare ABCS reduces production costs: cost-effectiveness ratio is not a limitation for its use. In terms of patient satisfaction, cosmetic/functional outcomes (general appearance, texture, flexibility, sensitivity and colour) of ABCS and split-thickness autografts are not different statistically.
Burn Unit, Department of Burns, Plastic and Reconstructive Surgery, Hospital Universitario de Getafe, Madrid, Spain. cristinnagm@hotmail.com
C
C
Gómez
J M
JM
Galán
V
V
Torrero
I
I
Ferreiro
D
D
Pérez
R
R
Palao
E
E
Martínez
S
S
Llames
A
A
Meana
P
P
Holguín
D000293:Adolescent; D000328:Adult; D057005:Bioengineering; D002056:Burns / Q000601:surgery*; D002648:Child; D015331:Cohort Studies; D005260:Female; D005347:Fibroblasts / Q000473:pathology; D006801:Humans; D015603:Keratinocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D017768:Skin, Artificial; D023822:Tissue Engineering / Q000379:methods; D014182:Transplantation, Autologous; D055815:Young Adult