Can Skin Cells Improve Outcomes for Patients With Deep Burns?

Early excision and split-thickness skin autografts (STSGs) have become standard care for full-thickness burns, but healing the donor site challenges these patients who are already at metabolic and microbial risks, increasing with the total body surface area (TBSA) burned. Engineered skin substitutes containing 1 or more cellular or acellular components of the epidermis, dermis, or hypodermal components have been designed to function as potential STSG replacements, supplementing the barrier or scaffold functions of lost skin. They have reduced the area of STSG tissue needed, helping to improve mortality and healing of patients with large-area, full-thickness burns. Randomized clinical trials (RCTs) continue to explore new ways to optimize scarring, healing, tissue viability, timing, costs, and infection for patients with full-thickness burns2 or chronic wounds. Results for chronic wounds were often inconclusive, based on small studies using varied standards of care with non-blinded outcome evaluation, but evidence on burns is becoming more compelling. This Evidence Corner reviews recent studies that support further improvement of clinical or patient-centered outcomes for hospitalized patients with deep burn wounds managed with STSGs and autologous cultured epidermal cells5 or non-cultured autologous skin cell suspensions.