WOUND CLOSURE AND OUTCOME IN EXTENSIVELY BURNED PATIENTS TREATED WITHCULTURED AUTOLOGOUS KERATINOCYTES

Cultured autologous keratinocytes (CAK) have been heralded as a means to achieve more rapid closure of massive burn wounds. Despite the clai med benefits of this technology, we have failed to identify its positi ve impact on wound closure in extensively burned patients. Sixteen pat ients with a mean age of 29.7 years (range, 10-56 years) and a mean to tal body surface area burn of 68.2% (range, 42%-85%) underwent 22 appl ications of CAK supplied by a private laboratory. The keratinocyte gra fts were applied to a mean of 15.9% of the body surface area (range, 4 %-59%) at an average cost per patient of $43,705 (range, $9,800 to $16 1,000). The mean body surface area of definitive wound coverage by the se grafts was 4.7% (range, 0%-18.6%). The mean length of hospitalizati on was 132 days (range, 50-275 days). The observed mortality was 12.5% (two patients). Our experience with this wound care approach has been assessed with respect to the extent of burn, the level of wound excis ion, and the site of CAK application.