Spray-on skin better than grafts for some burns
When someone is seriously burned, they face a number of health challenges. In order to close the wound, doctors graft skin from other parts of the body, creating more wounds and increasing the risk of infection.
But a new system helps patients regenerate new skin.
Tacy Gash's whole life changed in five minutes on Memorial Day 2018, when her family home exploded. Gash and her husband, Bill, had just come home from grocery shopping when they noticed a strong smell of gas.
"I remember the click," Gash said. "I remember the whoosh of air because it was really hot. Strong whoosh of air. And I remember seeing pink. When I woke up in the hospital, I had burn marks that came around my face. It's because the flames came around and clapped my face, then moved on."
The flames burned Gash on 20% of her body. Her hands and legs were the worst. The heat had melted her skin to the carpet.
During her two weeks in the hospital, doctors recruited Gash for a clinical trial of Recell. It's a kit containing everything a doctor needs to take a small sample of a patient's own skin and turn it into a liquid with the cells needed to regrow new skin.
"Then, it gets sucked up into a syringe, and then the syringe is outfitted with an atomizer so that you can spray it on," Dr. Jeffrey Shupp said.
Gash says the areas treated with the spray skin healed flatter and the color is better than her burns treated with skin grafted from other areas of her body.
With Recell, a piece of healthy skin the size of a postage stamp can treat a burn 80 times that size.
"It means less donor sites for the patients, which decreases their total wound burden," Shupp said.
The Recell kit and spray skin procedure were approved by the Food and Drug Administration late last year.
Gash's husband, Bill, was not treated with the Recell because his burns covered 60% of his body and his injuries were too severe.
Bill and Tacy are still recovering and have rebuilt their home in Prince Frederick, Maryland, outside Washington, D.C.
TOPIC: SPRAY-ON SKIN BETTER THAN GRAFTS FOR SOME BURNS
REPORT: MB #4651
BACKGROUND: Burns can cause swelling, blistering, scarring and, in serious cases, shock, and even death. They also can lead to infections because they damage the skin's protective barrier. Treatment for burns depends on the cause of the burn, how deep it is and how much of the body it covers. Antibiotic creams can prevent or treat infections. For more serious burns, treatment may be needed to clean the wound, replace the skin, and make sure the patient has enough fluids and nutrition. There are three types of burns. First-degree burns damage only the outer layer of skin. Second-degree burns damage the outer layer and the layer underneath. Third-degree burns damage or destroy the deepest layer of skin and tissues underneath. (Source: https://medlineplus.gov/burns.html)
GRAFTING: Skin grafting is done in a surgical procedure that consists of the removal of injured tissue, selection of a donor site, harvesting, where the graft is removed from the donor site, and placing and securing the skin graft over the surgically-cleaned wound so it can heal. To help the graft heal and become secure, the area of the graft is not moved for five days following each surgery. During this immobilization period, blood vessels begin to grow from the tissue below into the donor skin, bonding the two layers together. Five days after grafting, exercise therapy programs, tub baths and other normal daily activities resume. (Source: https://www.healthpartners.com/hospitals/regions/specialties/burn-center/skin-grafting/)
NEW TECHNOLOGY: Jeffrey Shupp, MD, FACS, Burn Center Director at MedStar Washington Hospital Center explained how the spray on skin works, "It basically takes a piece of donor skin from the patient and enzymatically turns it into a cell suspension or a liquid skin that can then be sprayed back on the patient. In the traditional sense, we typically mesh four to one, three to one, even six to one. And what that means is that you will take a 200 square centimeter piece of skin and if you mesh it four to one, then you'll have eight hundred square centimeters of skin to graft with. The advantage of the ReCell technology is that you can actually mesh skin or expand skin 80 times that of its original size. So you can see the magnitude of the ability for you to get more coverage with smaller pieces of skin." (Source: Jeffrey Shupp, MD, FACS)