Artificial dermis for major burns. A multi-center randomized clinical trial

D. Heimbach, A. Luterman, J. Burke, A. Cram, David Herndon, J. Hunt, M. Jordan, W. McManus, L. Solem, G. Warden, B. Zawacki

Research output: Contribution to journalArticle

499 Citations (Scopus)

Abstract

This communication presents an 11-center prospective randomized trial using the artificial dermis invented by Burke and Yannas. Patients with life-threatening burns who underwent primary excision and grafting within 7 days of injury had comparable sites randomized to receive either the artificial dermis (study site) or the investigator's usual skin grafting material (control site). Control materials were autograft, allograft, xenograft, or a synthetic dressing. Epidermal grafts were applied to the study site during a second operation, and surviving patients were followed for 1 year after grafting. One hundred thirty-nine sites on 106 patients were studied. Mean burn size was 46.5±15% mean total body surface (TBSA). Overall mortality was 13%, and mean hospital stay was 68±45 days. Median artificial dermis take was 80% compared with 95% for all comparative sites, but the take was equivalent to that of all nonautograft control materials. Results with the artificial dermis improved slightly as the investigators became more familiar with the material. Donor site thickness for the study site averaged .006″±.002″ compared to .013″±.018″ for control (p<.0001) and the epidermal donor site healed an average of 4 days sooner (10±6 vs. 14±8 days) (p<.0001). As the wounds matured during the first year, both patients and surgeons felt that both sites became more comparable in appearance and function. At the completion of the study, there was less hypertrophic scarring of the artificial dermis, and more patients preferred the artificial dermis to the control graft. Artificial dermis with an epidermal graft provides a permanent cover that is at least as satisfactory as currently available skin grafting techniques, and uses donor grafts that are thinner and donor sites that heal faster.

Original languageEnglish (US)
Pages (from-to)313-320
Number of pages8
JournalAnnals of Surgery
Volume208
Issue number3
StatePublished - 1988
Externally publishedYes

Fingerprint

Dermis
Burns
Randomized Controlled Trials
Tissue Donors
Transplants
Skin Transplantation
Research Personnel
Autografts
Wounds and Injuries
Bandages
Heterografts
Cicatrix
Allografts
Length of Stay
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Heimbach, D., Luterman, A., Burke, J., Cram, A., Herndon, D., Hunt, J., ... Zawacki, B. (1988). Artificial dermis for major burns. A multi-center randomized clinical trial. Annals of Surgery, 208(3), 313-320.

Artificial dermis for major burns. A multi-center randomized clinical trial. / Heimbach, D.; Luterman, A.; Burke, J.; Cram, A.; Herndon, David; Hunt, J.; Jordan, M.; McManus, W.; Solem, L.; Warden, G.; Zawacki, B.

In: Annals of Surgery, Vol. 208, No. 3, 1988, p. 313-320.

Research output: Contribution to journalArticle

Heimbach, D, Luterman, A, Burke, J, Cram, A, Herndon, D, Hunt, J, Jordan, M, McManus, W, Solem, L, Warden, G & Zawacki, B 1988, 'Artificial dermis for major burns. A multi-center randomized clinical trial', Annals of Surgery, vol. 208, no. 3, pp. 313-320.
Heimbach D, Luterman A, Burke J, Cram A, Herndon D, Hunt J et al. Artificial dermis for major burns. A multi-center randomized clinical trial. Annals of Surgery. 1988;208(3):313-320.
Heimbach, D. ; Luterman, A. ; Burke, J. ; Cram, A. ; Herndon, David ; Hunt, J. ; Jordan, M. ; McManus, W. ; Solem, L. ; Warden, G. ; Zawacki, B. / Artificial dermis for major burns. A multi-center randomized clinical trial. In: Annals of Surgery. 1988 ; Vol. 208, No. 3. pp. 313-320.
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