title: A comparison of Biobrane™ and cadaveric allograft for temporizing the acute burn wound: Cost and procedural time.
abstract: BACKGROUND
  In many circumstances early burn excision and autografting is unsafe or even impossible. In these situations, skin substitute dressings can be utilized for temporary wound coverage. Two commonly used dressings for this purpose are cadaveric allograft and Biobrane™.
  
  
  METHODS
  Five year retrospective cohort study evaluating upper extremity burns treated with temporary wound coverage (Biobrane™ or allograft). The primary outcome was to determine the impact choice of wound coverage had on operative time and cost. The secondary outcome was the need for revision of upper extremity debridement prior to definitive autografting.
  
  
  RESULTS
  45 patients were included in this study: 15 treated with cadaveric allograft and 30 treated with Biobrane™ skin substitute. Biobrane™ had a significantly lower procedure time (21.12 vs. 54.78 min per %TBSA excised, p=0.02) and cost (1.30 vs. 2.35 dollars per minute per %TBSA excised, p=0.002). Both techniques resulted in 2 revisions due to complications.
  
  
  CONCLUSIONS
  Biobrane™ is superior to cadaveric allograft as a temporizing skin substitute in the acute burn wound, both in terms of procedure time and associated cost. We believe that this is largely due to the relative ease of application of Biobrane™. Furthermore, given its unique characteristics, Biobrane™ may serve as a triage and transport option for severe burns in the military and mass casualty settings.
authors.affiliation: Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Toronto, 149 College St, Stewart Building, 5th Floor, Toronto, ON M5T 1P5, Canada; Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, D704, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Electronic address: ry.austin@mail.utoronto.ca.
authors.forename: Ryan E
authors.initials: RE
authors.lastname: Austin
authors.affiliation: Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, D704, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Electronic address: merchant.nishant@gmail.com.
authors.forename: Nishant
authors.initials: N
authors.lastname: Merchant
authors.affiliation: Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Toronto, 149 College St, Stewart Building, 5th Floor, Toronto, ON M5T 1P5, Canada; Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, D704, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Electronic address: shar.shahrokhi@sunnybrook.ca.
authors.forename: Shahriar
authors.initials: S
authors.lastname: Shahrokhi
authors.affiliation: Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Toronto, 149 College St, Stewart Building, 5th Floor, Toronto, ON M5T 1P5, Canada; Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, D704, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Electronic address: marc.jeschke@sunnybrook.ca.
authors.forename: Marc G
authors.initials: MG
authors.lastname: Jeschke
mesh_terms: D000328:Adult; D000368:Aged; D001684:Biological Dressings / Q000191:economics*; D002056:Burns / Q000191:economics / Q000628:therapy*; D002102:Cadaver; D020099:Coated Materials, Biocompatible / Q000191:economics*; D015331:Cohort Studies; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D016038:Skin Transplantation; D017768:Skin, Artificial; D014182:Transplantation, Autologous
chemical_list: C042816:Biobrane; D020099:Coated Materials, Biocompatible
keywords: Allograft; Biobrane; Burn; Cost; Skin substitute