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Use of Autologous Cell Harvesting Device Reduces Number of Autografting Procedures Required for Treatment of Pediatric Full-thickness Burn Injuries
Kevin Foster1, Rajiv Sood2, Jeffrey E. Carter3, Joseph Molnar4, James H. Holmes, IV4
1Valleywise Health Medical Center, Phoenix, AZ; 2 Burn and Reconstructive Centers of America, Augusta, GA; 3 Louisiana State University, New Orleans, LA; 4 Wake Forest University School of Medicine, Winston-Salem, NC

Background (issue):In the US, approximately 23% of burn injuries occur in children. Management is based largely on depth, concomitant injuries, and donor skin availability. Autologous skin cell suspension (ASCS) provides a treatment strategy to significantly reduce donor skin required to achieve definitive closure, allowing a 80:1 expansion ratio. The purpose of this study was to evaluate the number of autografting procedures required to achieve definitive closure when ASCS was used to treat full-thickness thermal injuries compared to standard of care skin grafting (SOC). Methods:Real-world data in patients treated with ASCS <18 years of age collected in two prospective studies (NCT02992249 and NCT02994654) were compared to a cohort of matched patients from the American Burn Association’s National Burn Repository version 8.0 (NBR) receiving SOC. Propensity score stratification was used to reduce bias due to potential differences in key covariates between groups. Adverse events were compared to SOC derived from pivotal clinical data (NCT02380612) as the NBR was limited with respect to safety events.
Findings:The number of autograft procedures required to achieve definitive closure was statistically reduced within the ASCS cohort compared to the NBR control cohort (median 1 vs 2, p<0.0001 range 1-5 and 1-20, respectively). 91.8% of wounds were healed by Week 8. The number of patients experiencing a treatment-related adverse event was similar between groups (17.9% vs 20.0%, respectively).
Conclusions (implications for practice):Reduction in donor skin requirements and the number of autografting procedures are benefits associated with use of ASCS for pediatric full-thickness burns. In addition to burns, the safety and effectiveness of ASCS is currently being evaluated for other acute full-thickness injuries such as degloving and crush injuries, lacerations, and surgical wounds in a multicenter prospective randomized controlled trial (NCT04091672).


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