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A Single Center's 13-year experience with a 3-stage Dermal Regeneration Matrix Approach to the Acute Management of Hand Burns
Tiffany Jeong, Mario Alessandri Bonetti, Jose Antonio Arellano, Hilary Y Liu, Sumaarg Pandya, Guy Stofman, Francesco M Egro
University of Pittsburgh Medical Center, Department of Plastic Surgery
2024-01-09
Presenter: Tiffany Jeong
Affidavit:
Francesco M Egro
Director Name: Francesco M Egro
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Hand
Introduction
Dermal regeneration matrix (DRM) has been demonstrated to be safe and beneficial in improving functional outcomes for the management of acute hand burns. The aim of this study is to compare the surgical and functional outcomes of 2-staged DRM reconstruction and 3-staged reconstruction.
Methods
A retrospective study was conducted to review surgical and functional outcomes of patients treated for hand burns. All patients seen from April 2009 and December 2022 with hand burns, for who objective hand measurements were available, were considered for the study.
Results
From 2009 to 2023, 227 patients were treated for hand burns. Of them, 44 patients had objective hand measurements and were included in the study.
Most cases (n=27) received a 3-staged approach with cadaver allograft at first stage, dermal regeneration matrix (DRM) at second stage, and split thickness skin graft (STSG) for final reconstruction. Fewer cases received a 2-staged approach with DRM and STSG (n=10). Repeat STSG in acute management was significantly associated with patients who received the 2-staged (p<0.01).
There was no significant difference in mean baseline DASH scores(p=0.8033) for patients that received cadaveric allograft during acute management (46.5±22.3%) when compared to those who did not (48.7±22.5%). After completing OT, the DASH scores remained comparable (p=0.702) for 3-stage (30.17±20.3%) and 2-stage (26.2±23.4%) management.
Conclusion
These data suggest a 3-stage approach may conserve autologous STSG, with fewer instances of repeat grafting. This approach may be especially useful when autologous skin is limited.
