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A Survey of Skin Substitute Use Among Burn Surgeons Across the United States
Steffi Sharma, MD
Deepak K. Ozhathil, MD
Summa Health
2025-01-10
Presenter: Steffi Sharma, MD
Affidavit:
I agree and support the work that Steffi Sharma is submitting.
Director Name: Ananth Murthy
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction
A plethora of "skin substitutes" exist in burn care presenting a unique challenge to providers seeking to optimize product selection. We performed a cross-sectional survey of practicing burn surgeons to explore the products they utilized the indications for their use.
Methods
A 14-question survey was distributed to burn surgeons across the country. Contributors were actively practicing burn surgeons who identified skin substitutes they routinely use in practice and completed a separate product-specific survey on each product, covering aspects such as indication, usage frequency, clinical environment, perceived benefits, and practice changes due to lack of porcine xenograft availability. Statistical analysis involved descriptive statistics, Welch two-sample t-tests, and Pearson's correlation coefficient.
Results
Contributions were received from 48 surgeons across 39 institutions and 23 US states and Canada in 2022-2023. Over 20 products were reported. On average 4.3 skin substitutes were used per respondent, with no differences between academic and private institutions or based on years of practice. Substitutes included Dermal Regeneration Template (26 respondents) that was used for staged full-thickness burns. Polyurethane Foam (PF) (22 respondents), was used similarly and was believed to reduce dressing changes and healing time. Polylactic Acid Copolymer (PAC) (20 respondents) was used for middle thickness burns and cited for reduced dressing changes and healing time, whereas Biosynthetic Matrix (BM) (5 respondents) had mixed reviews.
Conclusions
Establishing a precise nomenclature for skin substitutes and sharing detailed benefit profiles could enhance clinical decision-making. Further research using more comprehensive surveys and blinded outcomes data will help optimize product selection.
