Abdominoplasty Panniculus as a Source for Human Acellular Dermis: A Preliminary Report.

BACKGROUND: In extensive deep dermal burn injuries, split-thickness skin graft (STSG) has been the most preferred treatment option for resurfacing burn wounds. A thick split-thickness skin graft is ideal for preventing graft contracture but is associated with delayed donor healing and the lack of adequate donor skin. When applied with STSG, the dermal substitutes offer better-reconstructed skin than STSG alone. Human-derived acellular dermal matrix (HADM) obtained from cadaver skin is a dermal equivalent with good clinical outcomes. However, high cost and limited cadaver donor skin availability limit its clinical utility. Developing a low-cost preparation method and finding an alternate source of human donated skin can help reduce the cost. The objective of this study was to explore the feasibility of making HADM from abdominoplasty panniculus skin. METHODS: Skin samples were collected from the abdominoplasty panniculus of ten eligible donors with their informed consent. A combination of low-cost reagents-sodium chloride and hypotonic solution (water for injection) was used for decellularizing the skin. Characterization of the prepared Acellular Dermis Matrix prototype was done. RESULTS: The skin was deepidermized with one molar NaCl treatment at 37 °C for 24 h. The deepidermized dermis became acellular with hypotonic solution treatment at 4 °C for two weeks. The hematoxylin and eosin staining and cytotoxicity test confirmed the acellularity and non-cytotoxicity of the prepared HADM prototype. The HADM prototype also facilitated the formation of neo-epithelium in the 3D cell co-culture model. CONCLUSION: This study confirms that abdominoplasty panniculus can be a viable alternative for HADM preparation. Further characterization studies are required to prove the concept.

Epidemiology of burn at a military hospital in Bahrain: initial experience of patient outcomes and quality indicators.

Burn injuries are one of the most common causes of morbidity and mortality in the world. We undertook a retrospective study to analyze the epidemiology and etiology of burn injuries at the burn unit of Bahrain Defence Force-Royal Medical Services from 2015 to 2016. The epidemiological and medical information were retrieved from the burn unit's (burn ward and burn intensive care unit (BICU)) medical records. The data were analyzed in Microsoft Excel. We observed that civilians were most affected by burn injuries and men were more affected than women. The age group of the maximally burnt patients differed between the burn ward and BICU. The age group of 21-30 years and 51-60 years were maximally affected by burn injuries among patients admitted in the BICU, whereas the 1-10 years age group dominated cases in the burn ward. Flame and scald burns contributed maximally to the burn cases in both years. TBSA 0-10% was the most commonly observed burn size. The length of hospital stay decreased from 2015 to 2016, possibly because of improvements in medical infrastructure and nursing care and opening of a burn dressing room. Wound dressing, surgical debridement and skin grafting of wounds were the predominant modes of treatment. Our results show that burn injuries remain an important public health issue and increase in public awareness about burn prevention and first aid should be emphasized for reducing the frequency of burn-associated mortalities.