Addendum: multicenter experience with cultured epidermal autograft for treatment of burns.

Since 1989 BioSurface Technology, Inc. (Cambridge, Mass.) has provided over 37,000 cultured epidermal autografts (CEAs) for more than 240 patients in 79 different burn centers in the United States and Europe. The average burn treated with BioSurface's CEA has been 70% total body surface area, half of that being full-thickness. Data, verified for 104 patients, indicate an average final "take" of about 60%, with half of all patients achieving a final take greater than or equal to 70% and 22% with final take greater than or equal to 90%. Sixteen percent of the patients had a take of less than 30%; many of these were associated with wound infection. Patient age, size of burn, and extent of full-thickness injury did not significantly affect take. Early excision followed by temporary coverage with homograft, which is allowed to engraft, was found to be associated with a low infection rate and a higher rate of CEA take. When engrafted homograft was only partially excised, leaving a layer of "allodermis" as the graft bed for CEA, take averaged 90% among 14 patients. Thus, our analysis of the extensive experience of many burn centers now permits more specific and helpful recommendations on standards of care to maximize efficacy of CEA.