Use of bilaminar grafts as life-saving interventions for severe burns: A single-center experience

•There are major limitations for the use of autografts.•Bilaminar Cultured Skin Grafts (BCSGs) were created in attempt to overcome autograft limitations.•First report investigating the long-term outcome of a newly developed BCSG.•The outcome with BCSG is substantially a better outcome compared to au...

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Bibliographic Details
Published in:Burns 2018-08, Vol.44 (5), p.1336-1345
Main Authors: Efanov, Johnny Ionut, Tchiloemba, Bianief, Duong, Antoine, Bélisle, Annie, Izadpanah, Ali, Coeugniet, Edouard, Danino, Michel Alain
Format: Article
Language:English
Subjects:
Autograft
Bilaminar grafts
Burns
Critical care
Plastic surgery
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Summary:•There are major limitations for the use of autografts.•Bilaminar Cultured Skin Grafts (BCSGs) were created in attempt to overcome autograft limitations.•First report investigating the long-term outcome of a newly developed BCSG.•The outcome with BCSG is substantially a better outcome compared to autografts. Skin coverage remains a significant hurdle in large-sized burns. Recent advances have allowed to grow Bilaminar Cultured Skin Autografts (BCSGs) from patients’ own donor sites. The aim of this study was to report long-term outcomes in patients with large-sized burns having received BCSGs. Nine patients received BCSGs from January 2010 to May 2015. Except one patient who died during hospitalization, all patients were contacted. Four agreed to partake in the study. Patients were tested with the Vancouver Scar Scale (VSS), QuickDASH questionnaire and Burn Specific Health Scale (BSHS). Incisional biopsies of BCSGs were compared with patients’ autografts. From nine patients, mean age was 40 years and mean TBSA was 70.3%. For the four patients included, score averaged was 2.25 on the VSS, 29.5 on QuickDASH, 36/36 for psychosocial items and 63/84 for functional abilities on the BSHS. Compared with autografts, BCSGs demonstrated better pliability VSS and functionality. Biopsies showed no evidence of malignancy or atypical changes, but areas of hyperpigmentation. This is the first report investigating the long-term outcome of a newly developed BCSG. BCSGs demonstrated comparable results with patients’ autografts, functional outcomes on self-reported questionnaires and excellent psychological states. Precaution given the extensive unexpected hyperpigmentation must be taken and a randomized controlled study is underway.
ISSN:0305-4179
1879-1409
DOI:10.1016/j.burns.2018.01.020