Twenty-Five Years' Experience and Beyond with Cultured Epidermal Autografts for Coverage of Large Burn Wounds in Adult and Pediatric Patients, 1989-2015.

ABSTRACT

This report summarizes the characteristics of 954 burned patients treated with cultured epidermal autografts (CEA), the largest number of patients to date. Data collected include patient demographics, survival, and final graft take. Source data were provided by the treating physician or attending burn team. Safety data were provided by the treating physician, attending burn team, and the pharmacovigilance database. In this dataset collected between 1989 and 2015, 954 patients were treated with cultured epidermal autographs for burns. Three hundred twenty-five (34%) were pediatric patients and 628 (66%) were adult (≥22 years of age); age unknown for one patient. The mean percentage total BSA (TBSA) burned was 67% (±17), median graft take at discharge was 75%, and overall survival at discharge was 84% (804/954). Survival rates were similar for pediatric and adult patients (89% vs 82%, respectively) and higher than the similar patient population reported in the National Burn Repository. Median graft take at discharge was also similar for pediatric and adult patients (80% vs 73%, respectively). The most frequently reported adverse reactions were infections in both pediatric and adult patients. There were no signals of increased risk of adverse reactions in pediatric compared with adult patients. When used as an adjunct to conventional split-thickness skin grafting for treatment of large burns in pediatric and adult patients, the analysis in this report shows an increased survival rate for patients treated with CEA compared with that reported for patients in the National Burn Repository with comparable burns.