Effectiveness of Autologous Skin Cell Suspension in Large Total Body Surface Area Burns: Analysis of Clinical Outcomes and Patient Charges.

Autor:	Elkady D; Loyola University Chicago Stritch School of Medicine, Maywood, IL 60153, USA., Larson BM; Department of Surgery, Summa Health System, Akron, OH 44304, USA., Sharma S; Adult and Pediatric Burn Institute and Department of Surgery, Akron Children's Hospital, Akron, OH 44308, USA., McNinch NL; Adult and Pediatric Burn Institute and Department of Surgery, Akron Children's Hospital, Akron, OH 44308, USA.; Rebecca D. Considine Research Institute, Akron, OH 44308, USA., Beaucock B; Adult and Pediatric Burn Institute and Department of Surgery, Akron Children's Hospital, Akron, OH 44308, USA., Richard BL; Adult and Pediatric Burn Institute and Department of Surgery, Akron Children's Hospital, Akron, OH 44308, USA., Khandelwal A; Adult and Pediatric Burn Institute and Department of Surgery, Akron Children's Hospital, Akron, OH 44308, USA.
Jazyk:	angličtina
Zdroj:	Journal of burn care & research : official publication of the American Burn Association [J Burn Care Res] 2024 Nov 14; Vol. 45 (6), pp. 1489-1498.
DOI:	10.1093/jbcr/irae133
Abstrakt:	Autologous skin cell suspension (ASCS) is an adjunct to conventional split-thickness skin grafts (STSG) for acute burns, enhancing healing and reducing donor site requirements. This study validates ASCS's predictive benefits in hospital stay reduction and cost savings by analyzing outcomes and real-world charges post-ASCS implementation at a single institution. A retrospective study (2018-2022) included burn patients with ≥10% TBSA. The study population comprised 2 groups: burns treated either with a combination of ASCS ± STSG or with STSG alone. Outcomes included LOS, surgeries, infection, complications, days on antibiotics, and adjusted charge per TBSA. The ASCS ± STSG group demonstrated significantly shorter LOS (Mdn: 16.0 days, IQR: 10-26) than the STSG group (Mdn: 20.0 days, IQR: 14-36; P = .017), and fewer surgeries (Mdn: 1.0, IQR: 1-2) versus the STSG group (Mdn: 1.0, IQR: 1-4; P = .020). Postoperative complications were significantly lower in ASCS ± STSG (11% vs. 36%; P < .001). The STSG group had a longer distribution of antibiotic days (IQR: 0-7.0, min-max: 0-76) than the ASCS ± STSG group (IQR: 0-0, min-max: 0-37; P = .014). Wound infection incidence did not differ (P = .843). ASCS ± STSG showed a lower distribution of adjusted charge per TBSA (IQR: $10 788.5-$28 332.6) compared to the STSG group (IQR: $12 336.8-$29 507.3; P = .602) with a lower mean adjusted charge per TBSA ($20 995.0 vs. $24 882.3), although this was not statistically significant. ASCS ± STSG utilization demonstrated significant reductions in LOS, surgeries, postoperative complications, antibiotics, and potential cost savings. These findings underscore the practicality of integrating ASCS in burn management, offering substantial benefits to patients and healthcare institutions. (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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