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Background <p>Burn injuries are a major global health concern, especially when large areas of the body are affected, limiting the availability of healthy skin for autologous skin grafting. This makes traditional skin grafting challenging. Skin substitutes have been developed to address these challenges. To date, there is limited research on Pelnac dermal substitute use for treatment of acute deep dermal burn injuries. This study aims to evaluate the effectiveness of Pelnac dermal substitute in treating such injuries on the upper limb.</p> Methods <p>This randomized control trial was conducted on 46 cases of acute burn injuries presented to the Kasr Al-Ainy Cairo University Hospital’s burns unit from March 2021 to August 2022. The patients were divided into two groups: the Graft-Only Group, consisting of 23 patients, and the Pelnac Group, comprising 23 patients. The primary outcome was the graft take success rate. The secondary outcomes included scar quality assessment, functional outcomes, and patient satisfaction with aesthetic appearance and functional recovery.</p> Results <p>In terms of coverage success, Graft only Group achieved&#xa0;100% success rate, while&#xa0;Pelnac take was unsuccessful in the first 17 patients. Upon observing the first successful case, we noted that there was no dermis remaining after excision, prompting us to implement more thorough debridement from the outset to reach the subcutaneous fat or fascia. Consequently, the Pelnac coverage was successful in the subsequent four patients, with a 22.7% success rate, (followed by autografting as a&#xa0;second stage).&#xa0;In terms of scar quality improvement, as measured by the Vancouver Scar Scale, the Pelnac group had a significantly lower average VSS value&#xa0;(2.40∓1.52) compared to Graft Only Group (7.45∓1.68) with (P&lt;0.001).&#xa0;Pelnac Group also had significantly higher patient satisfaction with aesthetic appearance compared to the graft-only group (<i>P</i> &lt; 0.001). There were no significant differences between the two groups regarding patient satisfaction with functional recovery and the average DASH score (<i>P</i> &gt; 0.05).</p> Conclusions <p>Pelnac could be regarded as a promising modality for the treatment of acute full thickness burns and can be used in partial thickness burns, specifically in instances of major burns with extensive surface area damage.&#xa0;In these&#xa0;cases, more thorough debridement from the start, reaching a bed of fat or fascia, and then applying Pelnac to increase its take is essential, to serve as a&#xa0;protective cover for the wound bed where it helps to prevent fluid loss and contamination.&#xa0;Level of Evidence: Level I, therapeutic study.</p>

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A novel technique for enhancing the take of Pelnac® dermal substitute in deep dermal burns of the upper limb: a randomized controlled trial

  • 期刊论文

  • 发表日期：

    2025年2月10日

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  • Heidi Ashraf Rady,
  • Adel Michel Wilson,
  • Ahmed Adel Nawar,
  • Laila Ahmed Aboul Nasr

摘要

Background

Burn injuries are a major global health concern, especially when large areas of the body are affected, limiting the availability of healthy skin for autologous skin grafting. This makes traditional skin grafting challenging. Skin substitutes have been developed to address these challenges. To date, there is limited research on Pelnac dermal substitute use for treatment of acute deep dermal burn injuries. This study aims to evaluate the effectiveness of Pelnac dermal substitute in treating such injuries on the upper limb.

Methods

This randomized control trial was conducted on 46 cases of acute burn injuries presented to the Kasr Al-Ainy Cairo University Hospital’s burns unit from March 2021 to August 2022. The patients were divided into two groups: the Graft-Only Group, consisting of 23 patients, and the Pelnac Group, comprising 23 patients. The primary outcome was the graft take success rate. The secondary outcomes included scar quality assessment, functional outcomes, and patient satisfaction with aesthetic appearance and functional recovery.

Results

In terms of coverage success, Graft only Group achieved 100% success rate, while Pelnac take was unsuccessful in the first 17 patients. Upon observing the first successful case, we noted that there was no dermis remaining after excision, prompting us to implement more thorough debridement from the outset to reach the subcutaneous fat or fascia. Consequently, the Pelnac coverage was successful in the subsequent four patients, with a 22.7% success rate, (followed by autografting as a second stage). In terms of scar quality improvement, as measured by the Vancouver Scar Scale, the Pelnac group had a significantly lower average VSS value (2.40∓1.52) compared to Graft Only Group (7.45∓1.68) with (P<0.001). Pelnac Group also had significantly higher patient satisfaction with aesthetic appearance compared to the graft-only group (P < 0.001). There were no significant differences between the two groups regarding patient satisfaction with functional recovery and the average DASH score (P > 0.05).

Conclusions

Pelnac could be regarded as a promising modality for the treatment of acute full thickness burns and can be used in partial thickness burns, specifically in instances of major burns with extensive surface area damage. In these cases, more thorough debridement from the start, reaching a bed of fat or fascia, and then applying Pelnac to increase its take is essential, to serve as a protective cover for the wound bed where it helps to prevent fluid loss and contamination. Level of Evidence: Level I, therapeutic study.