716 Autologous Skin Cell Suspension for Dorsal Hand Burn Treatment

TL;DR

This study explores using autologous skin cell suspensions to treat hand burns, showing good recovery and less donor site damage compared to traditional methods.

Contribution

The study demonstrates the effectiveness of autologous skin cell suspensions in dorsal hand burn treatment with minimal donor site morbidity.

Findings

ASCS allowed immediate postoperative occupational therapy and good functional outcomes in most patients.

Nine out of ten patients achieved full upper extremity range of motion by discharge.

One patient required autografting due to ASCS failure, but most healed well without major complications.

Abstract

Intermediate and deep partial-thickness dorsal hand burn injuries require timely and appropriate care to preserve both form and function. Split-thickness autografting (STAG) remains the standard of care but requires postoperative immobilization and a large donor site. Autologous skin cell suspensions (ASCS) are prepared from a small piece of autograft and are an alternative to STAG for partial thickness burns. They have minimal donor site morbidity and do not require postoperative immobilization. This study aims to assess the utility of ASCS in the treatment of intermediate and deep partial thickness burns of the dorsal hand.

This IRB-approved retrospective case series identified patients at a regional burn center with intermediate and deep partial-thickness hand burn injuries who were treated with ASCS alone. Data on injury etiology, demographic information, complications, functional variables, and treatment outcomes were collected.

Ten male right-hand dominant patients with intermediate to deep partial thickness dorsal hand burns were identified, with a mean total body surface area involvement of 12.0±9.3%. On average, patients received ASCS alone for their hand burns on post-burn day 7.3±2.5. All ten patients resumed occupational therapy on postoperative day one. Nine patients had full upper extremity range of motion on day of discharge, which occurred on average 9.1±7.0 days after surgery. Four patients developed hypertrophic scarring without range of motion limitation of the ASCS treated hand. One patient experienced ASCS failure and required autografting for wound closure.

This retrospective case series presents ASCS as an effective wound closure strategy for intermediate to deep partial thickness hand burn injuries. In select patients, ASCS minimizes donor site morbidity and permits immediate upper extremity rehabilitation with excellent functional outcomes..

This research highlights the potential benefits of using ASCS for the treatment of dorsal hand burn injuries and thus suggests a possible change in current burn would management.