title: The use of skin substitutes and burn care-a survey.
abstract: OBJECTIVE
  The aim of our Internet survey was to assess the preferences of burn specialists who use skin substitutes in patients with burns covering 20% or more of their total body surface area (TBSA).
  
  
  METHODS
  An open, voluntary Internet-based cross-sectional survey was performed. Responses to 19 noncompulsory questions, and participant career and location information were collected.
  
  
  RESULTS
  One hundred eleven specialists from 36 countries responded to our questionnaire. Sixty participants were located in Europe (54%), followed by 31 (28%) in North America, 15 (14%) in Asia, three (3%) in South America, one (1%) in Africa, and one (1%) in Australia. The importance of skin substitutes in medium-sized burns (covering 20%-60% TBSA) was rated as "essential" by 28% and "desirable" by 56% of the respondents. In severe burns >60% of TBSA, 81% of responders rated the use of skin substitutes as "essential" and 14% as "desirable". Skin substitutes were used in daily clinical practice by 96% of all participants. Biological and synthetic dressings were used by 53%. A majority (86%) think that biological dressings do not pose a risk to patients. Allografts represent the most frequently used wound coverage (51%), followed by xenografts (28%). All participants of the survey indicated that as of yet, there is no ideal skin substitute available.
  
  
  CONCLUSIONS
  Split-thickness autografts still represent the most used wound cover for definitive treatment of severe burns. However, creation and implementation of an ideal skin substitute have yet to be achieved and therefore should be the focus of future work.
authors.affiliation: Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, Texas; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria. Electronic address: wurzer_paul@gmx.at.
authors.forename: Paul
authors.initials: P
authors.lastname: Wurzer
authors.affiliation: Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Hildegard
authors.initials: H
authors.lastname: Keil
authors.affiliation: Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, Texas; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Ludwik K
authors.initials: LK
authors.lastname: Branski
authors.affiliation: Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Daryousch
authors.initials: D
authors.lastname: Parvizi
authors.affiliation: Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, Texas; Sealy Center for Molecular Medicine and the Institute for Translational Sciences, The University of Texas Medical Branch, Galveston, Texas.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Clayton
authors.affiliation: Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, Texas; Sealy Center for Molecular Medicine and the Institute for Translational Sciences, The University of Texas Medical Branch, Galveston, Texas.
authors.forename: Celeste C
authors.initials: CC
authors.lastname: Finnerty
authors.affiliation: Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, Texas.
authors.forename: David N
authors.initials: DN
authors.lastname: Herndon
authors.affiliation: Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Lars P
authors.initials: LP
authors.lastname: Kamolz
mesh_terms: D002056:Burns / Q000628:therapy*; D006801:Humans; D017768:Skin, Artificial / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: Allograft; Autograft; Burn injury; Internet survey; Skin substitute; Total body surface area; Xenograft