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. 2009 Jun 26:9:e25.

Experience with biobrane: uses and caveats for success

John E Greenwood  1 , Jill Clausen, Sheila Kavanagh
Affiliations

Experience with biobrane: uses and caveats for success

John E Greenwood et al. Eplasty. .

Abstract

Objective: To present some of our experience with Biobrane (a total of 703 patients in 7 years) in a range of uses in burn practice and to illustrate the caveats that we have found applicable in maintaining our success with this versatile material.

Methods: Retrospective analysis of theatre records, medical notes, and photography database to categorize our experience with Biobrane. Thorough assessment of our surgical and nursing protocols (both literature and experience influenced) to identify caveats for successful use.

Results: Pivotal steps are revealed in wound selection, wound preparation, material application, dressing, and subsequent nursing care that have led to overwhelming success in definitive management of superficial partial thickness to middermal burns (ensuring pain relief, allowing early mobilization, tolerance of dressing changes and therapy, and earlier hospital discharge). Its many uses in a broad range of common burn situations are demonstrated and tips provided to achieve best outcome.

Conclusions: Biobrane is not a panacea but it is extremely versatile. The different potential uses have learning curves, and suggestions are provided to flatten these.

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Figures

Figure 1
Figure 1
Cross-sectional electron micrograph of Biobrane structure.
Figure 2
Figure 2
Definitive management of superficial partial thickness burns with Biobrane. An extensively blistered burn wound (a) is meticulously cleaned (b) a Biobrane glove has been applied (c) excellent healing occurs by day 9 (d).
Figure 3
Figure 3
Graft reduction; the superficial burn components heal with Biobrane while the deeper area demarcates allowing accurate grafting with minimal sacrifice of viable tissue.
Figure 4
Figure 4
Salvage in the elderly; initially appearing superficial, this burn in a 78-year-old struggled to heal spontaneously but resulted in the best outcome.
Figure 5
Figure 5
Once the deeper areas have been excised, Biobrane holds the graft and allows the superficial surrounds to heal spontaneously. Note that the nipple has been excluded from the Biobrane and has been treated with Betadine ointment.
Figure 6
Figure 6
Forehead dermabrasion receives Biobrane, which is also used to retain a cell suspension.
Figure 7
Figure 7
An 80% TBSA burn (a) receives Biobrane initially as a temporizing dressing (b and c) and later to hold meshed graft and cultured cell suspension (d) resulting in healing (e).
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References

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    1. Demling RH. Use of Biobrane in management of scalds. JBCR. 1995;16(3, suppl):329–30. - PubMed
    1. Purdue GF, Hunt MD, Gillespie RW, et al. Biosynthetic skin substitute versus frozen human cadaver allograft for temporary coverage of excised burn wounds. J Trauma. 1987;27(2):155–7. - PubMed
    1. McHugh TP, Robson MC, Heggers JP, et al. Therapeutic efficacy of Biobrane in partial and full-thickness thermal injury. Surgery Oct. 1986;100(4):661–4. - PubMed

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