Treating Burns Faster to Reduce Patient Trauma

By Matt Phillion

Every year, over 450,000 people in the U.S. suffer burns severe enough to need medical intervention. Treatment isn’t simple: beyond just the physical healing process, there is an emotional toll to burns that is lasting. Research shows that a third of burn survivors experience dissatisfaction with their body image, which can lead to significant psychological distress, anxiety, depression, and PTSD.

Skin regeneration technology has made significant leaps forward, with Spray-On Skin™ Cells offering new hope to burn patients. Faster and less invasive than conventional skin grafting techniques, Spray-On Skin Cells regenerative technology reduces risks of pain, delayed healing, discoloration, scarring, and the need for multiple procedures.

Using a sample roughly the size of a postage stamp, Spray-On Skin Cells regenerative technology speeds up wound healing and helps reduce hospital stays, minimize scarring, and provide better matches with the patient’s natural skin tones.

Its use for wound closure helps move the needle in terms of patient safety and reducing risk, says Dr. Katie Bush, SVP of Scientific & Medical Affairs with AVITA Medical.

“One of the biggest challenges surgeons face in burn treatment is wound closure. Patients come in with injuries, are stabilized and ready to be treated, and the question is: how do we get closure for those patients?” says Bush. “It’s a well-known fact that the longer a patient’s wound remains open and doesn’t have closure, the more likely scarring outcomes become.”

Those early days matter, says Bush.

“With the well-known correlation between scarring and the wound remaining open, it’s extremely important that we think about that from the time the patient is coming in,” she says.

Currently the most common procedure for wound closure for burns is a skin graft, where healthy skin is removed from the same patient, also known as a donor site and applied to the burn wound.

“As you can imagine, creating a second wound site comes with its own risks. The site you harvest skin from is often painful, exposing nerves, opening up risk to infections, and the potential for scarring,” says Bush. “And for patients who have comorbidities—diabetes, immunocompromised—there are additional risks. Or in the case of pediatric patients or those with very large burn injuries, there may simply not be enough skin to use.”

This leaves healthcare professionals in a predicament: How do they get wound closure for these patients? And if I do, what are all the challenges associated with the most used procedure?

“By not treating these patients sufficiently and leaving wounds open, they are susceptible to infection. There really is no other option. You need to get closure, because otherwise you’ll end up with an infection or the body will try to heal on its own, which causes scarring and contracture. You’ll have an impact on cosmesis, functionality, and for the patient, this can negatively impact their quality of life.”

The limitations of current technology

Technology has evolved to improve upon the limitations of traditional skin grafts—the most basic of which is methods to increase the amount of space or size of the area skin grafts can offer through the use of meshing. Meshing involves fenestrating the graft to expand the amount of area the graft will cover.

“There’s limitations to that,” says Bush. “You’re essentially creating small holes in the graft which doesn’t have the most optimal outcomes” in terms of avoiding scarring. “So we’ve looked into epidermal coverage strategies. How can we use regenerative medicine to harness what we know these skin cells can do and use that to our advantage?”

Other options remain in development, such as taking biopsies from the patient to create sheets of skin that are placed back on the patient, but such concepts don’t consider the urgency so often at the forefront of treating burn patients.

“It’s a pretty large advancement in burn care, but it doesn’t address the time. It still takes three to four weeks to culture out and it’s a pretty costly process,” says Bush.

Instead, Bush says, AVITA Medical provides a solution harnessing the ability of human skin cells to regenerate and provide closure in a faster way.

“It allows the surgeon at the point of care to use a biopsy, right there in the OR, to create spray-on skin cells that can be placed immediately back onto the patient,” says Bush.

One of the things that is most innovative about this technique, she explains, is the expansion ratio.

“The surgeon is able to take 1 square centimeter of skin and treat 80 square centimeters. You could take a sample the size of a credit card and cover the patient’s entire back,” she says.

This is in comparison to meshing techniques, which can double or triple the coverage.

“It’s a major advancement and allows for significant donor-sparing capabilities,” says Bush.

The technology was approved by the FDA in 2018 for the treatment of burns but has since been expanded to full-thickness skin effects, such as the results of necrotizing, infectious disease, cancer treatments, or trauma.

“This allows us to actively be able to talk to a much broader group of individuals beyond burn surgeons to treat more patients,” says Bush. “Now with the expanded indications we can talk to anyone who is treating these full-thickness skin defects within and beyond the burn community.”

AVITA Medical’s RECELL system is in most burn centers in the country, but the ability to use the treatment for other injuries and indications helps enable broader trauma centers, plastics centers, and hospitals to access the option.

“Our focus has been around the reduction of the burden of burns, from both the patient perspective and the healthcare provider perspective. Being able to reduce the amount of skin that is needed to treat these patients and get robust healing by using the spray on skin has been well received,” says Bush.

They have also looked at other impacts and found decreasing numbers of surgeries required for definitive wound closure.

“We’re seeing an impact on the length of hospital stay,” says Bush. “There’s an economic benefit in addition to the clinical benefit.”

They have also developed and received FDA approval for their RECELL GO device, which streamlines the preparation process and allows the surgeon and staff to spend less time with the device and more time with the patient.

“This was a pretty big advancement for us. We’re really simplifying the user interface, which reduces the training burden and improves workflow efficiencies,” Bush says. “This will make it easier for people to adopt the technology.”

All of this works toward reduced burden and improved outcomes for these at-risk patients.

“The biggest thing is really reducing the burden of burns. This is an innovative technology that allows for robust health outcomes, both at the treatment and donor sites,” says Bush. “It alleviates a lot of pain around the donor sites and the clinical outcomes we’re seeing translate into overall cost savings, decreasing the number of operations, decreasing length of stay, and helping those patients get back to their lives.”

Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at matthew.phillion@gmail.com.