• Annals of surgery · Sep 2024

    Benefits of Aerosolized, Point-of-care, Autologous Skin Cell Suspension (ASCS) for the Closure of full Thickness Wounds from Thermal and Non-Thermal Causes: Learning Curves from the first 50 Consecutive cases at an Urban, Level 1 Trauma Center.

    • C Scott Hultman, Ursula C Adams, Corianne D Rogers, Minakshi Pillai, Samantha T Brown, Carrie Ann McGroarty, Michelle McMoon, and M Georgina Uberti.
    • Department of Plastic and Reconstructive Surgery, WakeMed Health and Hospitals, Raleigh, NC.
    • Ann. Surg. 2024 Sep 1; 280 (3): 452462452-462.

    ObjectiveTo determine the utility of Autologous Skin Cell Suspension (ASCS) in closing full-thickness (FT) defects from injury and infection.BackgroundAlthough ASCS has documented success in closing partial-thickness burns, far less is known about the efficacy of ASCS in FT defects.MethodsFifty consecutive patients with FT defects (burn 17, necrotizing infection 13, crush 7, degloving 5, and other 8) underwent closure with the bilayer technique of 3:1 widely meshed, thin, split-thickness skin graft and 80:1 expanded ASCS. End points were limb salvage rate, donor site reduction, operative and hospital throughput, incidence of complications, and re-epithelialization by 4, 8, and 12 weeks.ResultsDefinitive wound closure was achieved in 76%, 94%, and 98% of patients, at 4, 8, and 12 weeks, respectively. Limb salvage occurred in 42/43 patients (10 upper and 33 lower extremities). The mean area grafted was 435 cm 2 ; donor site size was 212 cm 2 , representing a potential reduction of 50%. The mean surgical time was 71 minutes; the total operating room time was 124 minutes. The mean length of stay was 26.4 days; the time from grafting to discharge was 11.2 days. Four out of 50 patients (8%) required 6 reoperations for bleeding (1), breakdown (4), and amputation (1). Four out of 50 patients (8%) developed hypertrophic scarring, which responded to silicone sheeting (2) and laser resurfacing (2). The mean follow-up was 92.7 days.ConclusionsWhen used for the closure of FT wounds, point-of-care ASCS is effective and safe. Benefits include rapid re-epithelialization, high rate of limb salvage, reduction of donor site size and morbidity, and low incidence of hypertrophic scarring.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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