Conservative Management Of Partial-Thickness Scald Burns In Children Using Cultured Allogenic Keratinocyte Spray: Initial Experience Of 18 Patients Treated In An Outpatient Setting.

Abstract

The objective of this study was to describe our clinical experience with the use of cultured allogeneic keratinocyte (CAK) using a simplified cell delivery method in the treatment of pediatric partial-thickness scald burns treated as outpatients in a Burn Unit. An actuator fitted onto a 3ml syringe was used for cell spray. Eighteen patients having active mixed partial-thickness burn wound areas of <10% total body surface area (TBSA), treated between 2017 and 2019, were included in the study. The wounds were managed conservatively with a combination of burn dressings using hydrogels and CAK application. The timing of the CAK application was decided by the treating plastic surgeon based on his clinical judgment and the clinical status of the wound. The primary study endpoints were the number of days and dressing changes required for complete wound reepithelialization. All of the eighteen patients' wounds reepithelialized completely with CAK application, with a mean reepithelialization time of 10.33 (±4.95) days after the application of CAK. The median value for the number of CAK applications and total dressing sessions required to achieve complete healing were 3 and 4 times, respectively. Wounds treated with CAK application between 8-21 days after burn injury required fewer cell application sessions and fewer dressing changes than wounds treated within seven days and after 21 days from the burn injury. None of the patients reported any adverse reaction related to CAK use. The present study suggests that non-extensive mixed partial-thickness scald burn in children can be successfully treated conservatively using CAK as an adjunct in addition to standard dressing in the outpatient setting.