Is Timing Everything? Navigating the Burn Wound Healing Process with Biobrane

Gayatri Caplash¹, Timothy Chew ², Marcus Wagstaff³,
¹Royal Adelaide Hospital, Adelaide, South Australia, Australia
²Royal Adelaide Hospital, Adelaide, South Australia, Australia
³Royal Adelaide Hospital, Adelaide, South Australia, Australia

Abstract

Aim:
Biobrane® is a biosynthetic dressing that is commonly used for the management of partial-thickness burns. It performs the function of the lost epidermis until re-epithelialisation occurs. Biobrane® has been shown to reduce analgesic requirements, healing time, inpatient nursing requirements and length of inpatient stay compared to traditional dressings. Given theatre constraints and delayed patient presentations, the traditionally described Biobrane “window of use” of 24 hours can be challenging to achieve. At the Royal Adelaide Hospital (RAH) Burns Unit, Biobrane® is applied under a general anaesthetic within 48 hours of a burn injury. This study aims to analyse if outcomes of burns vary based on the timing of Biobrane® application, with the primary outcome being infection rates.

Method:
A retrospective, single-centre analysis was performed of patients with partial thickness burns managed with Biobrane® for three years (2020-2022) at the RAH. Data was collected on burn mechanism, % TBSA and site, timing to application of Biobrane® (<12 hours, 12-24 hours, 24-48 hours, 48-72 hours), and timing of removal. Outcomes measures included infection, need for early removal of Biobrane®, return to theatre, need for skin grafting and delayed healing. Our analysis showed that despite patients undergoing Biobrane® placement after the 24-hour window, our unit’s infection and complication rates were low. Conclusion: This study indicates that strict adherence to the 24-hour Biobrane ® window may not be unnecessary. There currently is no universal protocol for the use of Biobrane®, and more research and collaboration between units is required.

Biography

Unaccredited Plastic and Reconstructive/Burns Surgery registrar currently working at the Royal Adelaide Hospital.