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Even Better Than The Real Thing? Comparison Of Xenograft To Autograft For The Treatment Of Pediatric Scald Injuries: Review Of Outcomes And Costs At A Single, Accredited Burn Center, From 2004-2013
Board Board 1 / Mon 15:30, 13 Apr 2015

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The Use of Xenografting in Pediatric Patients with Scald Injury: Single Institution 10 year review

Paul Diegidio MD, Shiara Ortiz-Pujols MD, Jonathan Friedstat MD, David Spratte, Marisa C Gray, Samuel Jones MD, David van Duin MD PhD, David J Weber MD MPH, Bruce A Cairns MD, Charles S Hultman MD MBA

University of North Carolina, Chapel Hill, NC



Scald injuries remain the most common type of burn in children, and best practices continue to evolve. Depending on depth of injury, management can range from non-operative wound care to excision and autografting. In 2004, we introduced and standardized early xenografting for intermediate partial-thickness wounds at our institution. We report our 10-year experience with pediatric scald burns, comparing xenografting to autografting in terms of cost, length of stay, healthcare-associated infections (HAI), and cosmetic outcomes.


Using prospectively collected data submitted to the National Burn Repository, verified by individual chart review, we identified all patients < 18 years old, admitted to our burn center, who sustained scald burns from 2004-2013. Patients were divided into three cohorts, based on wound closure method: Autograft, Xenograft, Non-Operative. We then compared the Autograft and Xenograft cohorts by two tailed t-test and chi-square analysis.


A total of 1867 children with scald burns were admitted from 2004-2013. Compared to autografting, patients who underwent xenografting tended to be younger, but had a similar TBSA. An analysis of inpatient variables revealed that patients in the Xenograft group had a lower incidence of HAI, shorter ICU and facility stays, and less expensive hospitalizations. In the outpatient arena we found that the Xenograft group had decreased development of hypertrophic scar formation (outpatient referral to a plastic surgeon) and need for reconstruction.


Xenografting is a more cost-effective method of wound closure than autografting for children with partial thickness scald injuries. While non-operative management may be appropriate for small/superficial burns, xenografting provides rapid wound closure for intermediate size burns, and burns with large surface area. Autografting may be reserved for obvious deep partial thickness and full thickness burns. Xenografting also permits earlier hospital discharge, reduces need for reconstruction, and should strongly be considered as first line therapy for intermediate-depth pediatric scald injuries.



1) “Pediatric Burns Fact Sheet”; The Burn Foundation.  Feb 3rd, 2015. http://www.burnfoundation.org/programs/resource.cfm?c=1&a=12.

2) Lee EW . Zoografting in a burn case. Boston Med Surg 1880;103:260.

3) Diegidio P. Chapter 1: The Use and Uses of Large Split Skin Grafts of Intermediate Thickness by Blair VP, and Brown JB (1929) in 50 Studies Every Plastic Surgeon Should Know. Edited by C.S. Hultman. CRC Press, Taylor & Francis Group; Boca Raton, FL (2014).

4) Chiu T, Burd A. “Xenograft” dressing in the treatment of burns. Clin Dermatol. 2005 Jul-Aug;23(4):419-23.

5) Zimlichman E, Henderson D, Tamir O, et al. Health Care-Associated Infections; A Meta-analysis of Cost and Financial Impact on the US Health Care System. JAMA Intern Med. 2013;173(22):2039-2046.

6) Glance LG, Stone PW, Mukamel DB, et al. Increases in Mortality, Length of Stay, and Cost Associated With Hospital Acquired Infections in Trauma Patients. Arch Surg. 2011 July; 146(7):794-801.

7) Zajicek R, Matouskova E, Broz L, et al. New biological temporary skin cover Xe-Derma® in the treatment of superficial scald burns in children. Burns. 2011 Mar;37(2):333-7.

8) Hosseini SN, Mousavinasab SN, Fallahnezhat M. Xenoderm dressing in the treatment of second degree burns. Burns. 2007 Sept;33(6);776-81.

9) Hermans MHE. Porcine xenografts vs. (cryopreserved) allografts in the management of partial thickness burns: Is there a clinical difference? Burns. 2014 May;40(3):408-15.

10) Jiong C, Jiake C, Chunmao H, et al. Clinical Application and Long-Term Follow-Up Study of Porcine Acellular Dermal Matrix Combined with Autoskin Grafting. J Burn Care Res. 2010 Mar-Apr;31(2):280-5.

11) Weber DJ, van Duin D, Dibiase LM, et al. Healthcare-associated infections among patients in a large burn intensive care unit: incidecnea nd pathogens, 2008-2012. Infect Control Hosp Epidemiol. 2014 Oct;35(10):1304-6.

12) Feng X, Tan J, Pan Y, et al. Control of hypertrophic scar from inception by using xenogenic (porcine) acellular dermal matrix (ADM) to cover deep second degree burn. Burns. 2006 May;32(3)293-8.

13) Chen X, Shi Y, Shu B, et al. The effect of porcine ADM to improve the burn wound healing. Int J Clin Exp Pathol. 2013 Oct 15;6(11):2280-91.

14) Barone AAL, Mastroianni M, Farkash EA, et al. Genetically modified porcine split-thickness skin grafts as an alternative to allograft for provision of temporary wound coverage: preliminary characterization. Burns. 2014 Oct. http://dx.doi.org/10.1016/j.burns.2014.09.003 (Epub, ahead of print).

15) Chiu T, Shah M. Porcin Xenograft dressing for facial burns: beware of the mesh imprint. Burns 2002 May; 28(3) 279-82.

16) Hassan Z, Shah M. Porcine Xenograft dressing for facial burns: meshed versus non-meshed. Burns 2004;30(7):753.

17) Duteille F, Perrot P. Management of 2nd-degree facial burns using the Versajet(®) hydrosurgery system and Xenograft: a prospective evaluation of 20 cases. Burns. 2012 Aug;38(5):724-9.

18) Sun T, Han Y, Chai J, Yang H. Transplantation of microskin autografts with overlaid selectively decellularized plit0thickness porcine skin in the repair of deep burn wounds. J Burn Care Res 2011 May-June;32(3):e67-73.

19) Chen X, Feng X, Xie J, et al. Application of acellular dermal xenografts in full-thickness skin burns. Exp Ther Med. 2013 Jul;6(1):194-8.


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