The use of Suprathel® in deep dermal burns: First results of a prospective study

• Published in: Burns 2012-05, Vol.38 (3), p.388-395
• Main Authors: Keck, M, Selig, H.F, Lumenta, D.B, Kamolz, L.P, Mittlböck, M, Frey, M
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Burn wound; Burns; Burns - pathology; Burns - surgery; Cicatrix - pathology; Critical Care; Female; Humans; Male; Medical sciences; Middle Aged; Polyesters - therapeutic use; Prospective Studies; Re-epithelialisation; Scar formation; Skin; Skin substitutes; Skin Transplantation - methods; Skin, Artificial; Traumas. Diseases due to physical agents; Wound Healing
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2011.09.026

Abstract Introduction While autologous skin grafting has been the standard for coverage of full-thickness areas, several options for deep-partial-thickness defects exist. With regard to economising donor sites, we compared a copolymer based on dl -lactid acid (Suprathel® ) as temporary wound dressing with autologous skin, and analysed time to healing and scar quality in matched areas of deep-partial-thickness burn. Methods We recruited 18 patients with a median age of 45 years (range: 25–83 years), for this prospective, non-blinded controlled non-inferiority study, suffering from deep-partial-thickness burns from November 2009 to July 2010. After early tangential excision, matched deep-partial-thickness areas were covered with 1:1.5 meshed autologous skin grafts and the copolymer for direct intra-individual comparison. Scars were evaluated by means of the Vancouver Scar Scale (VSS), the Patient and Observer Scar Assessment Scale (POSAS) and suction cutometry (MPA 580, Courage and Khazaka Electronic GmbH, Cologne, Germany) on days 30 and 90, postoperatively. Results Fifteen days after surgery, complete wound closure was present in 44.4% (8/18) of all areas covered with copolymer and 88.9% (16/18) in the split-thickness skin graft (STSG) area ( p = 0.008). Evaluation of the total VSS, POSAS and cutometry satisfied the criterion of non-inferiority for Suprathel® on day 30. Ninety days after surgery, only the Observer Scar Scale showed that Suprathel is non-inferior to STSG, albeit the mean total VSS and Patient Scar Scale were better in Suprathel® areas. Conclusion Suprathel® represents a solid, reliable epidermal skin substitute with longer healing times in comparison to skin grafts but comparable results concerning early scar formation. Suprathel® can serve as a tool in treatment portfolio for adult patients suffering from deep dermal burns. Especially in patients with extensive burns, Suprathel® can be used to cover the deep dermal burn wounds to save STSGs and its donor sites for the coverage of full-thickness burned areas.