Delgado-Miguel Carlos, García Morán Ada, Fuentes Gómez Lara, Díaz Mercedes, Miguel-Ferrero Miriam, López-Gutiérrez Juan Carlos
Department of Pediatric Surgery, Fundación Jiménez Díaz University Hospital, Avenida de los Reyes Católicos, 2, 28040, Madrid, Spain.
Institute for Health Research IdiPAZ, La Paz University Hospital, Madrid, Spain.
Eur J Pediatr. 2024 Dec 13;184(1):80. doi: 10.1007/s00431-024-05916-6.
Early debridement of partial-thickness burns and coverage with skin substitutes is currently the standard of care in children, although there is currently no "gold standard" skin substitute. Our aim is to compare the effectiveness of three different skin substitutes, analyzing the medium- and long-term outcomes.
A retrospective study was conducted on burn patients under 18 years admitted to our Burn Unit between 2015 and 2021, who were divided into 3 groups according to the type of skin substitute used (EZ-derm®, Biobrane®, and Suprathel®). Demographic and clinical data and short- and long-term outcomes were analyzed. Effectiveness was analyzed by escharectomy and grafting rate during acute management and long-term follow-up reintervention rate. A total of 378 patients were included (179 EZ-derm® group, 107 Biobrane® group, and 92 Suprathel® group). No differences in demographics or burn characteristics were observed between the groups. Patients treated with Suprathel® had a significantly shorter hospital stay (median 4 days (IQR 2-9)), a lower rate of escharectomy and grafting during acute management (21.1%), and a lower long-term follow-up reintervention rate (18.5%) when compared to the EZ-derm® group (median stay 9 days (IQR 6-13); escharectomy and graft 24.6% and reintervention 26.8%) and to the Biobrane® group (median stay 9 days (IQR 7-14); escharectomy and graft 32.1% and reintervention 26.2%).
Treatment of partial-thickness burns with Suprathel® is associated with a shorter hospital stay, lower need for escharectomy and grafting, and lower need for long-term reintervention. Therefore, it should be considered the treatment of choice for pediatric partial-thickness burns.
• Different types of skin substitutes are available for the treatment of skin burns in paediatric patients.
• Suprathel® is linked to a reduction in hospital stays, a lower need for escharectomy and grafting, and a lower likelihood of requiring long-term re-interventions.
目前，儿童部分厚度烧伤的早期清创及皮肤替代物覆盖是标准治疗方法，尽管目前尚无“金标准”皮肤替代物。我们的目的是比较三种不同皮肤替代物的有效性，分析其中长期疗效。
对2015年至2021年期间入住我院烧伤科的18岁以下烧伤患者进行回顾性研究，根据所用皮肤替代物类型分为3组（EZ - derm®、Biobrane®和Suprathel®）。分析人口统计学和临床数据以及短期和长期疗效。通过急性处理期间的焦痂切除和植皮率以及长期随访再干预率分析有效性。共纳入378例患者（EZ - derm®组179例、Biobrane®组107例、Suprathel®组92例）。各组间在人口统计学或烧伤特征方面未观察到差异。与EZ - derm®组（中位住院时间9天（四分位间距6 - 13天）；焦痂切除和植皮24.6%，再干预26.8%）和Biobrane®组（中位住院时间9天（四分位间距7 - 14天）；焦痂切除和植皮32.1%，再干预26.2%）相比，使用Suprathel®治疗的患者住院时间显著缩短（中位4天（四分位间距2 - 9天）），急性处理期间焦痂切除和植皮率较低（21.1%），长期随访再干预率较低（18.5%）。
使用Suprathel®治疗部分厚度烧伤可缩短住院时间，减少焦痂切除和植皮需求以及长期再干预需求。因此，应将其视为儿童部分厚度烧伤的首选治疗方法。
• 有不同类型的皮肤替代物可用于治疗儿科患者的皮肤烧伤。
• Suprathel®与住院时间缩短、焦痂切除和植皮需求降低以及长期再干预可能性降低相关。
