title: The CelluTome epidermal graft-harvesting system: a patient-reported outcome measure and cost evaluation study.
abstract: Conventional split skin grafts (SSG) require anaesthesia, specialist equipment and can have high donor site (DS) morbidity. The CelluTome epidermal graft-harvesting device is a novel alternative, providing pain-free epidermal skin grafts (ESG) in the outpatient setting, with projected minimal DS trauma and improved patient satisfaction. This study aimed to compare ESG with SSG by evaluating patient-related outcome measures (PROMs) and the cost implications of both. Twenty patients answered a graft satisfaction questionnaire that evaluated: donor/graft site noticeability, aesthetic concerns, adverse problems and patient satisfaction. Cost/patient was calculated based on total operative expenses and five clinic follow-ups. In 100% of the ESG cases, there were no DS noticeability or adverse problems compared to 25% in the SSG group. Complete satisfaction with DS appearance was observed in 100% of the ESG cases (50% SSG). Noticeability, adverse problems and overall satisfaction were significantly better in ESG cases (P < 0.05). Graft site parameters were comparable with similar healing outcomes. The cost per patient for ESG was £431 and £1489 for SSG, with an annual saving of £126 960 based on 10 grafts/month. For the right patient, CelluTome provides comparable wound healing, with reduced DS morbidity and higher patient satisfaction.
authors.affiliation: Royal Free Wound Healing Group, Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK.
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Smith
authors.affiliation: Royal Free Wound Healing Group, Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK.
authors.forename: Sarah-Jayne
authors.initials: SJ
authors.lastname: Edmondson
authors.affiliation: Royal Free Wound Healing Group, Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK.
authors.forename: Nicki
authors.initials: N
authors.lastname: Bystrzonowski
authors.affiliation: Royal Free Wound Healing Group, Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK.
authors.forename: Nadine
authors.initials: N
authors.lastname: Hachach-Haram
authors.affiliation: Royal Free Wound Healing Group, Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK.|Department of Surgery and Interventional Science, University College London, London, UK.
authors.forename: Muholan
authors.initials: M
authors.lastname: Kanapathy
authors.affiliation: Royal Free Wound Healing Group, Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK.|Department of Surgery and Interventional Science, University College London, London, UK.
authors.forename: Toby
authors.initials: T
authors.lastname: Richards
authors.affiliation: Royal Free Wound Healing Group, Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK.|Department of Surgery and Interventional Science, University College London, London, UK.
authors.forename: Ash
authors.initials: A
authors.lastname: Mosahebi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D004817:Epidermis / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D016038:Skin Transplantation / Q000191:economics* / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000191:economics* / Q000379:methods*; D014945:Wound Healing / Q000502:physiology*
keywords: CelluTome; Cost analysis; Epidermal skin grafting; Patient-recorded outcome measures; Split skin grafting