Fetal bovine dermis as an alternative to allograft in large burn injuries

Abstract

Introduction: Dermal substitutes can be an essential treatment option for patients with very large burn injuries. We reviewed and compared our experience with a fetal bovine dermis dermal substitute versus allograft for adult burn patients with large burn injuries. Methods: After obtaining regulatory approval from our local institutional review board, we performed a 1 year retrospective review of adult burn patients with a TBSA of 50% or greater who underwent grafting with either fetal bovine dermis or allograft. We collected data that included age, TBSA, length of stay, number of operations,% area grafted with either allograft or fetal bovine dermis, and time between allograft or fetal bovine dermis grafting to autografting. All mean values are mean ± standard deviation, and all median values are median (interquartile range) Results: Overall for this review 15 patients met entry criteria. The mean age was 36 ± 9 years and mean TBSA was 71 ± 15%. Mean area grafted with either allograft (ALLO) or fetal bovine dermis (FBD) was 20 ± 8%. Mean time from grafting with ALLO or FB was 30 ± 12 days. There was no difference in median age between the ALLO group (30 (26–31)) and FBD group (35 (32–46) and there was no difference in median TBSA between the ALLO group (68(60–75)%) and FBD group (69(59–88)%). The median area grafted with allograft was 20(20–30)% which was not significantly different than the median area grafted with FBD (16.5(11–26)%). Additionally, there was no difference between the time from grafting with ALLO to autologous skin grafting (26(22–36) days) and the time from grafting with FBD to autologous skin grafting (25.5(21–32) days). Conclusions: Fetal bovine dermis is an acceptable alternative to allograft in patients with a large TBSA burn-injury. Further studies are needed to determine if infectious and functional outcomes are improved with fetal bovine dermis. Keywords: Dermal substitute, Fetal bovine dermis, Severe burn injury