Treatment of second degree facial burns with allografts—preliminary results

Horch, Raymund E.; Jeschke, Marc G.; Spilker, Gerald; Herndon, David N.; Kopp, Jürgen

doi:10.1016/j.burns.2005.01.011

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Volume 31, Issue 5 , Pages 597-602, August 2005

Treatment of second degree facial burns with allografts—preliminary results

Raymund E. Horch
- Department of Plastic and Hand Surgery, Medical School, Friedrich-Alexander-University, Erlangen-Nürnberg 12, 91054 Erlangen, Freiburg, Germany
- Corresponding author. Tel.: +49 9131 85 33277; fax: +49 9131 85 39327.
Marc G. Jeschke
- Department of Plastic and Hand Surgery, Medical School, Friedrich-Alexander-University, Erlangen-Nürnberg 12, 91054 Erlangen, Freiburg, Germany
- Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, USA
Gerald Spilker
- Department of Plastic, Reconstructive and Hand Surgery and Burn Center, City of Cologne Hospital, Cologne-Merheim, Germany
David N. Herndon
- Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, USA
Jürgen Kopp
- Department of Plastic and Hand Surgery, Medical School, Friedrich-Alexander-University, Erlangen-Nürnberg 12, 91054 Erlangen, Freiburg, Germany

Abstract

Facial burns are very common and have significant clinical impact. However, the treatment regimen for superficial to deep facial burns is not well defined. The purpose of this study was to investigate the effects of cadaver skin grafting in deep partial thickness facial burns in comparison to standard care.

In a prospective open study design severely injured patients with superficial and deep partial thickness burns were randomized into the group receiving open treatment with silversulfadiazine (standard n=5) or into the group receiving early superficial debridement followed by coverage with glycerolized cadaver skin (n=5). The outcome measures were time and quality of wound healing, and incidence of hypertrophic scarring at 3 and 6 months post burn.

There were no significant differences in demographics between groups. In the group treated with the allogenic material time to reepithelialization was 10.5 days, while it was 12.4 days in the silversulfadiazine group (p<0.05). Scar quality was found to be significantly improved in the allogenic treatment group. Three and 6 months postburn there were no patients with significant hypertrophic scarring in the allogenic group while there were two patients who developed hypertrophic scars in the silversulfadiazine group (p<0.05).

In this study, we demonstrated that glyzerolized cadaver allograft skin represents a superior biological dressing for shallow and deep partial thickness facial burns. This is in concordance with other reports on scalds. It would be worthwhile to perform more clinical studies with a larger number of patients to further evaluate the effect and function of allogenic skin for facial burns.

Keywords: Facial burns, Allograft, Scar quality