D Barnes¹, A Tan², Natalie Whybro³, Q Frew⁴, N El-Muttardi⁵, B Philp⁶, P Dziewulski⁷.

¹ St Andrews Centre for Plastic and Burns, Court Road, CM1 7TH, UK, David.barnes@meht.nhs.uk
² St Andrews Centre for Plastic and Burns, Court Road, CM1 7TH, UK, alethea.tan@doctors.org.uk
³ St Andrews Centre for Plastic and Burns, Court Road, CM1 7TH, UK, Natalie.Whybro@meht.nhs.uk
⁴ St Andrews Centre for Plastic and Burns, Court Road, CM1 7TH, UK, qfrew@hotmail.com
⁵ St Andrews Centre for Plastic and Burns, Court Road, CM1 7TH, UK. Naguib.El-Muttardi@meht.nhs.uk
⁶ St Andrews Centre for Plastic and Burns, Court Road, CM1 7TH, UK, Peter.Dziewulski@meht.nhs.uk

Introduction

Keratinocyte cell sprays such as ReCell® has allowed the clinical application of autologous epidermal cells by immediate processing and delivery of a complete population of cells for re-epithelisation. Its use with skin substitutes and several wound dressings have also been shown to be safe but varies between burn units and appears to depend on surgeon preference. This study aims to review the practice of burn wound management using ReCell® to better understand its indication in a regional burn service.

Methods

A 3 year retrospective analysis of all patients who had ReCell® application was conducted. Data was collected from case notes on patient demographics, burn demographics, operation details and patient outcomes.

Results

48 patients were identified. Age ranged from 9 months to 75 years (median = 6 years). 45/47 operations were acute procedures whilst 2 were delayed burn reconstruction. Median TBSA = 17.5 (range 4.5 to 85). We noted highest concurrent usage with Biobrane, followed by meshed grafts, Allografts and sandwich technique. Median application day following burn injury was 2 days (range 1-64 days). Median healing time was 25 days (range 4 -102 days).  Six patients had pigmentation mismatch.

Conclusion

In our service, Recell® has been found useful in the following indications:

1. ReCell® + Biobrane® for paediatric scald injury
2. ReCell® over 4:1 sandwich technique
3. ReCell® to SSG donor sites

Further multi-centre studies are required to streamline the clinical indications for ReCell®, taking into account costings and objective measurement of patient outcomes.

Key Words

Burn wound resurfacing; Recell; indications.

Biography

I am a consultant burn and reconstructive plastic surgeon at St Andrew Centre for Plastics and Burns, Chelmsford. Previously, I trained in North East England and did a specialist burn fellowship at Middlemore Hospital at Auckland which I thoroughly enjoyed. I have completed a  MSc in  Health Science and a degree in Biomedical Engineering. I play an active role in research and innovation in burns. Currently, I also hold the role of an educational tutor for the hospital and I am the current deputy of London South East Burn Network.