The standard treatment of deep dermal to full thickness burns is surgical removal of the burn followed by skin transplantation. Dermal substitutes are increasingly used in the treatment of deep burns to replace lost dermis. Preservation of the collagen and elastin in the acellular human dermal substitute Glyaderm provides a more elastic scar. It is unknown what the effect of Glyaderm on scar quality is in a solely paediatric population. The objective of this case series is to investigate scar maturation and scar quality when applying Glyaderm in deep dermal to full thickness burns in a pediatric population aged ≤15 years old.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
20
All included patients will undergo full thickness removal of the burned skin or adequate debridement of all necrotic tissue. Next, the dermal substitute Glyaderm followed by a split thickness skin graft will be transplanted on the wound.
Radboudumc
Nijmegen, Netherlands
RECRUITINGScar quality (clinician)
Scar quality measured using the Patient and Observer Scar Assessment Scale (POSAS) Observer Scale, which rates the scar from 1 (=like normal skin) to 10 (=worst scar imaginable).
Time frame: 12 months
Clinical assessment of the graft take
Take of the split thickness skin graft (STSG) in percentages. The take is defined as STSG that appears vital and is adherent to the wound bed.
Time frame: 5-7 days after STSG application
Wound epithelialization
Wound epithelialization is the percentage of the graft with a vital skin graft and healed graft interstices.
Time frame: 5-7 days after STSG application
Wound healing time
\>95% epithelialization of the wound area is considered as healed
Time frame: determined in the first several days to weeks after STSG application
Donor site healing time
\>95% epithelialisation of the donor site wound surface area is considered as healed
Time frame: determined in the first several days to weeks after STSG application
Scar surface area
The scar surface area is calculated using the surgery wound as reference area
Time frame: day of surgery (day 0) and 3, 6 and 12 months post-surgery
Scar quality (participant)
Scar quality measured using the Patient and Observer Scar Assessment Scale (POSAS) Patient Scale, rating the scar from 1 (=like normal skin) to 10 (=worst scar imaginable).
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Time frame: 3, 6 and 12 months post-surgery
Occurrence of scar contractures
Scar contractures often occur in children with deep dermal and full thickness burn wounds.
Time frame: Up to 12 months post-surgery
Occurrence of scar hypertrophy
Scar hypertrophy often occurs in children with deep dermal and full thickness burn wounds.
Time frame: Up to 12 months post-surgery
Range of motion of affected joints
When joints are affected due to the burn wound, the range of motion of the affected joint(s) will be monitored during follow-up.
Time frame: 3, 6 and 12 months post-surgery