Efficacy of hydrosurgical excision combined with skin grafting in the treatment of deep partial-thickness and full-thickness burns: A two-year retrospective study

Have the recent advancements in wound repair and scar management technology improved the quality of life in burn patients?

BACKGROUND

The negative physical and psychosocial impact of scars, in particular burn scars, has been well documented. Altered personal appearance together with impaired function related to pain, heat intolerance, and contracture formation may last a lifetime and eventually can lead to low self-esteem and poor social and psychological adjustments. Though most patients recover within the first years and many report generally good life satisfaction and moderate quality of life (QoL), some severely burned patients continue to report impaired QoL almost 10 years after injury. It is repeatedly mentioned in the literature that patients' QoL and health-related quality of life (HRQoL) can be improved by improving wound healing and burn scar quality. Determining whether advances in burn wound healing and scar management modalities are positively impacting the lives of surviving patients is the aim of this review.

METHODS

A systematic literature review was used to identify studies measuring QoL of patients surviving severe burn injuries following various interventions to improve burn wound healing and scar quality.

RESULTS

A limited number of studies was identified. Given the limited available data, a narrative review approach including qualitative studies and reviews in addition to identifying common themes, trends, and gaps in the existing literature was deemed more appropriate for a comprehensive analysis.

CONCLUSION

The assumption that progress made in recent decades to improve burn wound healing and scar quality would improve QoL remains largely hypothetical. Except for functional release of burn scar contractures, improved scar aesthetic quality does not necessarily translate into improved QoL of surviving patients. Well-designed comparative studies are largely lacking.

Strategies for Optimizing Acute Burn Wound Therapy: A Comprehensive Review

Recent advancements in acute burn wound therapy are transforming the management of burn injuries, with a focus on improving healing times, graft integration, and minimizing complications. However, current clinical treatments face significant challenges, including the difficulty of accurately assessing wound depth and tissue viability, which can lead to suboptimal treatment planning. Traditional closure methods often struggle with issues such as delayed wound closure, limited graft survival, inadequate tissue regeneration, and insufficient vascularization. Furthermore, managing infection and minimizing scarring remain persistent obstacles, impacting functional recovery and aesthetic outcomes. Key areas of innovation include advanced imaging techniques that enable more precise assessment of wound depth, size, and tissue viability, allowing for more accurate treatment planning. In addition, new closure strategies are being developed to accelerate wound closure, enhance graft survival, and address challenges such as tissue regeneration, vascularization, and infection prevention. These strategies aim to optimize both functional recovery and aesthetic outcomes, reducing scarring and improving the quality of life for burn patients. While promising, these emerging techniques require further research and clinical validation to refine their effectiveness and expand their accessibility. Together, these innovations represent a significant shift in acute burn care, offering the potential for more personalized, efficient, and effective treatments.

Efficacy of hydrosurgical eschar excision following MEEK microskin grafting in patients with massive burns: A retrospective study of a single center

INTRODUCTION

One of the most common traumatic injuries, burn injuries lead to at least 180,000 deaths each year worldwide. Massive burns result in severe tissue loss and increase the rate of infection. Eschar excision with skin grafting is the gold standard of treatments for massive burns. Retaining dermis tissue is the key to ensuring the survival of skin grafts and rapidly closing exposed tissues. Traditional eschar excision with Humby or Weck knife controls the depth of excision until the dermis, but ensuring the accuracy of excision is challenging. Hydrosurgery minimizes damage to uninjured tissues during the removal of necrotic tissues. A foot pedal is used to adjust debridement depth for precise debridement. To figure out the clinical advantages and risks of using hydrosurgery in treating massive burns, this study has been conducted.

METHOD

Forty-two patients with massive burns and total body surface area (TBSA) of > 30% were treated at the First Affiliated Hospital of Anhui Medical University from May 2020 to January 2023. They underwent hydrosurgical eschar excision with MEEK microskin graft (n = 23) or tangential excision with MEEK microskin graft (n = 19).

RESULT

No statistically significant differences (p > 0.05) in the following demographics were found between the two groups: age, weight, TBSA, deep-partial-thickness burn, gender, inhalation injury, shock, excision area, and MEEK ratio. By contrast, statistically significant differences in per unit area of operation time, per unit area of operation spending, hospitalization cost, hospitalization duration, wound-healing time, skin graft survival, and scar quality were found between hydrosurgical excision group with MEEK microskin graft and conventional excision group with MEEK microskin graft.

CONCLUSION

The hydrosurgical excision system showed better clinical effects for patients with massive burns.