自体皮肤细胞悬浮液对全身大面积烧伤的疗效:临床疗效和患者费用分析。

IF 1.5 4区 医学 Q3 CRITICAL CARE MEDICINE
Djoni Elkady, Brandon M Larson, Steffi Sharma, Neil L McNinch, Beverly Beaucock, B Lou Richard, Anjay Khandelwal
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引用次数: 0

摘要

自体皮肤细胞悬液(ASCS)是治疗急性烧伤的传统分层厚皮移植术(STSG)的辅助手段,可促进愈合并减少对供皮部位的要求。本研究通过分析一家机构实施 ASCS 后的疗效和实际费用,验证了 ASCS 在缩短住院时间和节约成本方面的预测优势。一项回顾性研究(2018-2022 年)纳入了 TBSA ≥10% 的烧伤患者。研究对象包括两组:使用 ASCS±STSG 组合治疗或仅使用 STSG 治疗的烧伤患者。研究结果包括住院时间、手术次数、感染、并发症、使用抗生素天数以及调整后的每 TBSA 费用。ASCS ± STSG 组的 LOS(Mdn:16.0 天,IQR:10-26)明显短于 STSG 组(Mdn:20.0 天,IQR:14-36;P = 0.017),手术次数(Mdn:1.0,IQR:1-2)明显少于 STSG 组(Mdn:1.0,IQR:1-4;P = 0.020)。ASCS±STSG 组的术后并发症明显较低(11% vs. 36%; P < 0.001)。STSG 组的抗生素使用天数分布(IQR:0-7.0,最小-最大:0-76)长于 ASCS ± STSG 组(IQR:0-0,最小-最大:0-37;P = 0.014)。伤口感染发生率没有差异(P = 0.843)。与 STSG 组(IQR:12,336.8 - 29,507.3 美元;P = 0.602)相比,ASCS ± STSG 组的每 TBSA 调整费用分布较低(IQR:10,788.5 - 28,332.6 美元),每 TBSA 平均调整费用较低(20,995.0 美元 vs. 24,882.3 美元),但无统计学意义。使用 ASCS±STSG 可显著减少住院时间、手术次数、术后并发症、抗生素和潜在的成本节约。这些研究结果强调了将 ASCS 纳入烧伤管理的实用性,为患者和医疗机构带来了巨大的利益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness of Autologous Skin Cell Suspension in Large Total Body Surface Area Burns: Analysis of Clinical Outcomes and Patient Charges.

Autologous skin cell suspension (ASCS) is an adjunct to conventional split-thickness skin grafts (STSG) for acute burns, enhancing healing and reducing donor site requirements. This study validates ASCS's predictive benefits in hospital stay reduction and cost savings by analyzing outcomes and real-world charges post-ASCS implementation at a single institution. A retrospective study (2018-2022) included burn patients with ≥10% TBSA. The study population comprised 2 groups: burns treated either with a combination of ASCS ± STSG or with STSG alone. Outcomes included LOS, surgeries, infection, complications, days on antibiotics, and adjusted charge per TBSA. The ASCS ± STSG group demonstrated significantly shorter LOS (Mdn: 16.0 days, IQR: 10-26) than the STSG group (Mdn: 20.0 days, IQR: 14-36; P = .017), and fewer surgeries (Mdn: 1.0, IQR: 1-2) versus the STSG group (Mdn: 1.0, IQR: 1-4; P = .020). Postoperative complications were significantly lower in ASCS ± STSG (11% vs. 36%; P < .001). The STSG group had a longer distribution of antibiotic days (IQR: 0-7.0, min-max: 0-76) than the ASCS ± STSG group (IQR: 0-0, min-max: 0-37; P = .014). Wound infection incidence did not differ (P = .843). ASCS ± STSG showed a lower distribution of adjusted charge per TBSA (IQR: $10 788.5-$28 332.6) compared to the STSG group (IQR: $12 336.8-$29 507.3; P = .602) with a lower mean adjusted charge per TBSA ($20 995.0 vs. $24 882.3), although this was not statistically significant. ASCS ± STSG utilization demonstrated significant reductions in LOS, surgeries, postoperative complications, antibiotics, and potential cost savings. These findings underscore the practicality of integrating ASCS in burn management, offering substantial benefits to patients and healthcare institutions.

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来源期刊
CiteScore
2.60
自引率
21.40%
发文量
535
审稿时长
4-8 weeks
期刊介绍: Journal of Burn Care & Research provides the latest information on advances in burn prevention, research, education, delivery of acute care, and research to all members of the burn care team. As the official publication of the American Burn Association, this is the only U.S. journal devoted exclusively to the treatment and research of patients with burns. Original, peer-reviewed articles present the latest information on surgical procedures, acute care, reconstruction, burn prevention, and research and education. Other topics include physical therapy/occupational therapy, nutrition, current events in the evolving healthcare debate, and reports on the newest computer software for diagnostics and treatment. The Journal serves all burn care specialists, from physicians, nurses, and physical and occupational therapists to psychologists, counselors, and researchers.
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