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Burned But Not Broke: The Cost-Effectiveness and Improved Outcomes of Poly-Lactic Acid Dressings in Acute Burn Care
Brandon M. Larson, MD; Djoni Elkady, BS; Richard B. Lou, MD; Anjay Khandelwal, MD
Summa Health
2023-01-30
Presenter: Brandon M. Larson
Affidavit:
This is the original work of the resident as stated below.
Director Name: Erica Laipply, MD
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: General Reconstruction
Purpose:
This study examines the clinical impact of a poly-lactic acid dressing (SUPRATHEL®) compared to nonadherent, contact layer dressing (Telfa ™) in burn patients treated with an autologous skin cell suspension (RECELL®). This is the first study to analyze cost effectiveness of a poly-lactic acid dressing for burns by citing real hospital costs rather than predictive modeling.
Methods:
This was a single-center, retrospective study of all inpatient pediatric and adult patients treated for acute burns of at least 10% TBSA from 2018 to 2022. Primary outcomes were length of stay, number of surgical procedures, wound infections, duration of antibiotics and total adjusted charges per TBSA. Statistical analysis included Wilcoxon Rank Sum Test and univariate regression.
Results:
Total of 76 patients (75% male, 25% pediatric), mean (SD) age 35 (22.6) years. There were 33 (43%) Telfa™ and 43 (57%) SUPRATHEL® subjects. Length of stay significantly shorter in SUPRATHEL® vs Telfa™ (medians 15 vs 28 days, Wilcoxon p<0.001). Group was a significant main effect for number of antibiotics days (Neg. Binomial Regression p-value=0.017) with an increase in Telfa™ vs SUPRATHEL® by a factor of 8.93 (CI=1.5-53.8), and for infection with higher odds in the Telfa™ subjects (Logistic Regression p-value=0.013, OR 5.80, 95% CI 1.45-23.24). Charges per %TBSA were $18,414 (95% CI $13,311-$23,518) for SUPRATHEL® and $4,324 (95% CI $-7,892-$16,540) higher for Telfa™, which was not significant (Quantile Regression p-value=0.482).
Conclusion:
Poly-lactic acid dressings can improve burn patient outcomes without significantly impacting total patient charges.
