Effectiveness of Autologous Skin Cell Suspension in Large Total Body Surface Area Burns: Analysis of Clinical Outcomes and Patient Charges.

ABSTRACT

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 two 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 = 0.017), and fewer surgeries (Mdn 1.0, IQR 1-2) versus the STSG group (Mdn 1.0, IQR 1-4; P = 0.020). Postoperative complications were significantly lower in ASCS ± STSG (11% vs. 36%; P < 0.001). 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 = 0.014). Wound infection incidence did not differ (P = 0.843). 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 = 0.602) 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.