AUTHORS: Robert H. Demling, M.D. Leslie DeSanti R.N.,  Dennis P. Orgill, M.D. Ph.D.

TRANSCYTE

D. CLINICAL USE IN PARTIAL THICKNESS BURNS AND EXCISED WOUNDS

Process of Application

Identify appropriate wound and clean surface

Thaw Transcyte and cut to fit wound, overlapping edges

Use of compression dressing for initial immobilization

1) USE ON SUPERFICIAL MID PARTIAL THICKNESS BURNS

FACIAL BURN

Cleaned superficial mid dermal burn	Adherence evident on day 1 after compression dressing removed
	Day 5: opacity of membrane reflective of re-epithelialization

2) USE ON PARTIAL THICKNESS FOOT BURN

3) HAND BURNS

	Use on palm burn. Good adherence at Day 1, Good Flexibility
	Hand burn with Transcyte closure on Day 10: Note opacity reflecting healing
	Day 16: Hand healed except for few patches on fingers

4) MID DERMAL FOOT BURN

Day 2: Good adherence and joint flexibility, Patient ambulating

Day 10: Note color change reflecting healing

 

5) BURN IN CHILD

 

Day 10: Transcyte in place, adhered over joint. Note: opacity reflecting healing

 

Day 12: Majority of burn healed. Area over knee still requires a few more days

 

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E.  EVIDENCE FOR EFFECTIVENESS

1) Partial Thickness Burns vs. Topical Agents

Robert H. Demling*, Leslie DeSanti

Trauma and Burn Center, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA

This study compared the effect of standard topical antibiotic management versus a biological skin substitute wound closure for mid-partial thickness burns of the face. Adult patients with mid-dermal facial burns produced by flash flames or flame exposure were studied using a randomized prospective study design. Total daily burn care time, pain (0-10 scale) and healing time were monitored. Immediately after partial thickness debridement, the entire face burn, including ears, was closed with a bioengineered skin substitute coated with fibronectin (TransCyte) or treated by the open technique using bacitracin ointment applied 2-3 times daily. 21 patients were studied, with 10 patients in the skin substitute group. We found a significant decrease in wound care time 0.35± 0.1 versus 1.9± 0.5 h, decrease in pain of 2± 1 versus 4± 2 and re-epithelialization time 7± 2 versus 13± 4 days in the skin substitute group compared to topical antibiotics. We can conclude that a bioengineered skin substitute significantly improves the management and healing rate of partial thickness facial burns, compared to the standard open topical ointment technique. 

© 1999 Elsevier Science Ltd and ISBI. All rights reserved.