Sepehr S. Lajevardi1, Peter K.M. Maitz2
1 Burns Unit, Concord Repatriation General Hospital, Concord, NSW, 2137, email@example.com
2 Burns Unit, Concord Repatriation General Hospital, Concord, NSW, 2137, firstname.lastname@example.org
Biobrane (Smith&Nephew, USA) is a biosynthetic xenograft composite skin substitute and its use has become widespread for the management of partial thickness burns. In this report we present the trends in the use of Biobrane in our unit which has been increasing significantly over a four year period.
Retrospective review of prospectively collected database of all inpatients and outpatients with burns treated with Biobrane at Concord Hospital from 2009 to 2012.
Total of 389 patients were treated with Biobrane over the four year period. 293 patients (75%) were inpatients with mean of 12.7% total body surface area (TBSA) burn; and 96 (25%) were treated in the outpatient department with mean of 2.5% TBSA burns. There was a significant increase from year to year in both groups. In the Inpatients there were 40 patients in 2009, 49 in 2010, 89 in 2011 and 115 in 2012. In the outpatient department there were 2 in 2009, 4 in 2010, 23 in 2011 and 67 in 2012. 4% of patient required subsequent debridement and skin grafting after initial treatment with Biobrane.
The use of Biobrane in the outpatient department is effective with 95% of patients having healed wounds. In the inpatient group Biobrane is used in three settings: to achieve healing in patients with partial-thickness only wounds, in conjuncture with partial skin grafting in patients with heterogeneous burns depth of partial and full-thickness burns and as a temporary wound closure, and in patients with large TBSA full-thickness burns following debridement. Our experience has shown the use of Biobrane is effective for all the three described settings and this has lead to its increasing use in our unit.
Dr Sepehr Lajevardi is a Plastics Surgical Trainee with Royal Australasian College of Surgeons. He is undertaking a PhD in early management of burns at The University of Sydney and has an interest in improving the care of burns patients before transfer to a burns unit.