Sermet Terzi, Omer Cennet, Busenur Kırımtay, Kemal Kosemehmetoglu, Ali Konan
While previous research supports the use of small donor sites for extensive burns, our findings suggest that, in smaller burn injuries, a donor-to-burn area ratio of 1: 2 provides more effective wound healing than further donor site reduction. The 14-day follow-up and reliance on a single thermal burn model limit the generalizability of these results. Future studies with extended observation, varied burn etiologies, and molecular or immunohistochemical analyses are needed to validate and expand upon these findings.
BACKGROUND: Deep second-degree burn treatment is often time-consuming and expensive, with split-thickness autografts being the current standard of care. Recently, noncultured autologous cell sprays have shown comparable efficacy. This study utilized an experimental animal model to determine the optimal donor-to-burn area ratio for this method.
METHODS: Twenty-four male Wistar-albino rats were assigned to three groups (A, B, and C), each receiving two standardized second-degree burn wounds (2 cm2) on the dorsal skin. On day 5 post-injury, treatments were applied as follows: Group A wounds were left untreated or underwent tangential excision; Group B received autologous cell spray from 2 cm2 and 1 cm2 donor sites; Group C received cell spray from 0.5 cm2 and 0.25 cm2 donor sites. On day 14, all animals were sacrificed. Wound healing was assessed macroscopically (necrosis percentage) and histopathologically (ulcer size and inflammation score, 0-3).
RESULTS: Necrotic area percentage in the first and second burn site of the groups A, B, and C were 15±0.15%, 13±0.1%, 6±0.05%, 6±0.05%, 17±0.15%, and 9±0.1% (mean±standard deviation [SD]), ulcer size was 1.5±2.0 mm, 0.8±1.6 mm, 0.4±0.7 mm, 0.1±0.4 mm 2.4±2.1 mm, and 1.3±1.7 mm (mean±SD), and the inflammatory response was 1.8±1.5, 1.5±1.2, 0.8±1.0, 0.5±1.1, 2.0±1.1, and 1.5±1.4 (mean±SD), respectively. All evaluated parameters were statistically significantly better in the second burn area of Group B compared to the untreated group (p=0.007, p=0.041, p=0.043).
CONCLUSION: While previous research supports the use of small donor sites for extensive burns, our findings suggest that, in smaller burn injuries, a donor-to-burn area ratio of 1: 2 provides more effective wound healing than further donor site reduction. The 14-day follow-up and reliance on a single thermal burn model limit the generalizability of these results. Future studies with extended observation, varied burn etiologies, and molecular or immunohistochemical analyses are needed to validate and expand upon these findings.