Early use of hydrosurgery (Versajet) and application of biobrane xenograft – a useful surgical treatment in avoiding skin grafting in deep partial thickness to full thickness facial burns

Dr Francesca Dudas1, Dr Fadie Aziz

1Concord Repatriation General Hospital, Concord, Australia


Background: Deep partial thickness and full thickness facial burns can be devastating both functionally and cosmetically to the patient. Where possible skin grafting should be avoided as secondary contraction leads to permanent scarring, disfigurement and complications such as ectropion. There is currently no consensus on the optimal treatment regime for these injuries.

Methods: Our centre uses the treatment modality of hydrosurgery using Versajet followed by the application of a Biobrane Xenograft to these burns.

Results: In the past 6 months our centre has treated 6 patients using this surgical intervention and all patients have avoided skin grafting to this area. In 5 out of 6 patients this was performed within the first 48 hours post burn injury.

Discussion: Versajet allows gentle debridement and removal of devitalised burnt tissue to a healthy bleeding bed. The Biobrane Xenograft is then applied as the primary dressing to promote wound healing and has resulted in excellent outcomes for our patients.

Conclusion: Moving away from tangential excision of deep partial and full thickness facial burns which removes all possible viable cells and instead using a hydrosurgery technique with a xenograft has resulted in excellent patient outcomes in our population and avoided a second surgery in the acute treatment.


I am a plastic and reconstructive surgery unaccredited registrar in Sydney. I am currently the burns registrar at a major burns centre in Australia.

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