The use of a bioactive skin substitute decreases length of stay for pediatric burn patients

Background: To optimize burn care for children, the authors introduced a pr otocol incorporating the use of a bioactive skin substitute, TransCyte (Adv anced Tissue Sciences, La Jolla, CA). This study was designed to determine whether this management plan was safe, efficacious, and decreased hospital inpatient length of stay (LOS) compared with conventional burn management i n children. Methods: All pediatric burns greater than 7% total body surface area (TBSA) that occurred after October 1999 underwent wound closure with TransCyte (n = 20). These cases were compared with the previous 20 consecutive burn cas es greater than 7% TBSA that received standard therapy. Standard therapy co nsisted of application of antimicrobial ointments and hydrodebridement. The following information was obtained: burn mechanism, age, size of burn, req uirement of autograft, and LOS. Data were analyzed using the student's t te st. Results: Data for age, percent TBSA burn and LOS are reported as means +/- SEM. The children who received standard therapy were 2.99 +/-0.7 years comp ared with those receiving TransCyte were 3.1 +/-0.8 years. There was no dif ference between the treatment groups with regard to percent TBSA burn: stan dard therapy, 14.3 +/-1.4% TBSA versus TransCyte, 12.7 +/-1.3% TBSA. There was no difference in the type of burns in each group, the majority were liq uid scald type, 70% in the standard therapy group versus 90% in the TransCy te group. Only 1 child in the TransCyte group required autografting (5%) co mpared with 7 children in the standard therapy group (35%). Children treate d with TransCyte had a statistically6 significant decreaed LOS compared wit h those receiving standard therapy, 5.9 +/-0.9 days versus 13.8 +/-2.2 days , respectively (P =.002). Conclusions: This is the first study using TransCyte in children. The autho rs found that this protocol of burn care was safe, effective, and significa ntly reduced the LOS. This new approach to pediatric burn care is effective and improves the quality of care for children with burns. J Pediatr Surg 3 6:1118-1121. Copyright (C) 2001 by W B. Saunders Company.