The use of Suprathel® Skin Substitute for Partial Thickness Burns in a UK Regional Burns Centre

M.Nizamoglu, N Fox, K Cranmer, H Gerrish, N Martin, D Barnes, N El-Muttardi, P Dziewulski
St Andrew's centre for plastic surgery & burns

Introduction
We aim to present our experience with the use and effectiveness of Suprathel®, a synthetic skin substitute, in a range of uses in burn practice for partial thickness burns in children and adults. 

Methods
Retrospective analysis of medical case notes from Jan 2014 to Feb 2017. The study evaluated re-epithelialization time, grafting, wound colonization, infection, length of hospital stay (LOS), wound over-granulation and hypertrophic scar formation. Suprathel® was applied after debridement, followed by Vaseline gauze or Silicone dressings, betadine gauze and bandages. Outer dressings were changed every 2 days unless Infection dictated otherwise.

Results
Eighteen patients (mean age 12.15 years, range 1–54) with a mean total body surface area (TBSA) of 9.7% (range 2.5 - 21) were included. 7 cases were superficial partial thickness, 11 cases were mixed depth with mid-deep dermal components. Median LOS was 9 days (range 2 - 26). Median re-epithelialization time was 15 days (range 9–48). 7 patients took over 21 days to heal. One patient developed hypertrophic scarring. 4 patients developed wound over-granulation. Suprathel® was applied to donor site in one case and directly to burn wound in 17 cases. 8 cases underwent Versajet debridement prior to application. Suprathel® failed to adhere in one case. Three patients needed further split skin grafting to areas initially managed with Suprathel®. 16 wounds were colonized during treatment, with 4 developing wound infection clinically. 

Conclusions
Suprathel® is a versatile dressing solution for adult and paediatric patients suffering from burns. The different potential uses have learning curves for the multidisciplinary team. Suprathel® has the advantage that it may also be used to treat mid to deep dermal burns. In patients with extensive burns, Suprathel® can be used to cover the deep dermal burn wounds to prioritise skin grafts and their donor sites for full thickness burned areas.