Thanks for the replies both
whytee and
Herbiejohnster66
One source I found suggests that the clinical indications of skin allograft use in burns are:
- Coverage of extensive full-thickness wounds
- Coverage of widely meshed skin autografts
- Healing of partial-thickness wounds
- Wound bed preparation and testing for later acceptance of autograft (1)
Another suggested that allograft is useful for higher TBSA burns and as a biological dressing for any superficial open wounds
Allograft is in high demand as a biological dressing for any superficial open wounds, not just burn victims. Skin allograft is the gold standard for treating burns in people who do not have enough skin to cover all of the injured areas of their bodies. Studies have shown that skin allografts are superior to topical antimicrobial dressings in partial thickness burns and can reduce complications and length of hospital stay in burn patients. (2)
A US Military study links the likelihood of allograft use with %TBSA – for 30-40% TBSA burns, allograft is used 50% of the time whereas in 50%+ TBSA burns, allograft is used in 90%+ patients. The US military study suggests that allograft rejection typically occurs within just 1-2 weeks. Placement is reported to be primarily on the trunk and extremities or as an adjunct over widely meshed autograft. Broadly speaking, the allograft is said to be used to “facilitate closure via both reepithelization in less severe burns and by preparation of the wound bed for delayed autografting in severe burns.” (3)
The military study authors are of the opinion that using allograft (which they refer to as CPA) has clear advantages over using standard dressings
…. in a population in which up to 27% of patients who die are killed by a bacterial infection, the attributable decrease in infection secondary to allograft use is clearly advantageous. The advantages of CPA use also extend to fewer dressing changes, pain reduction from decreased donor site surface area and an adherent physical barrier over the burned areas, and improved overall wound healing (3)
It seems that perhaps the two main uses for BTM as a temporary skin coverage might be
- coverage of less deep/partial thickness wounds in patients with large area burn and open wounds that will need grafting
- as an adjunct to widely meshed skin autografts?
In which case it would be an additional (not cannibalizing) market for BTM, offering not only clear clinical benefits over standard dressing use but also various other benefits over cadaver allograft?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676815/#:~:text=Allograft facilitates excision of burn,burn injury in pediatric patients.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9123452/
https://academic.oup.com/jbcr/article/34/1/168/4565997
(20min delay)