Journal article
Establishing Consensus of Best Practice for CEA Use in Treatment of Severe Burns: A US Burn Provider Delphi Study
Journal of burn care & research, Vol.45(5), pp.1287-1293
03/19/2024
DOI: 10.1093/jbcr/irae050
PMCID: PMC11379135
PMID: 38502864
Abstract
The goal of this study was to inform standards of best practice in the use of cultured epidermal autograft (CEA), manufactured in the United States, for treatment of patients with severe burns. The study was designed using the modified Delphi technique, a method for structuring group communication among experts to promote the development of consensus-based recommendations. Known areas of variability related to the stages of CEA treatment were identified by literature review prior to the study and were confirmed through qualitative interview with the experts. The areas included Preoperative Planning/Surgical Planning, Immediate Post-Operative Care, and Rehabilitation and Long-Term Care. A list of 22 questions was developed based on interviews with the experts, and a 3round Delphi technique was used to establish consensus (≥80% agreement). Following 3 rounds (quantitative, qualitative, and virtual roundtable meeting) of the Delphi study, important guidance for use of CEA treatment in severely burned patients gained consensus. Final key recommendations included minimum burn limit for CEA treatment (30%-50% TBSA), ideal biopsy timing (1-2 days), number of grafts (enough to cover; adjust 72 hours before application), use of dermal substrates (recommended) and wide meshed autograft underlay (recommended), optimal CEA drying time per day (open air >6 hours), slings used if CEA placed on extremities (recommended), dressing changes (performed every day, all at once, with all layers removed down to bridal veil), CEA backing removal (10-14 days post placement), heat lamps (can be used to aid the wound in drying, depending on clinical judgement), initial activity restrictions lifted (beginning 10 days after backing removal), compression garments (introduced at approximately 2 months post CEA surgery), lasers (CO2 laser can be introduced between 3 and 6 months post CEA surgery).
Details
- Title: Subtitle
- Establishing Consensus of Best Practice for CEA Use in Treatment of Severe Burns: A US Burn Provider Delphi Study
- Creators
- Paul Glat - Drexel UniversityLisa Quirk - Drexel UniversityScott Hultman - Duke UniversityJennifer Kesey - Texas Tech University Health Sciences CenterArpana Jain - Arizona Burn Center, Pheonix, AZ, USAJohn Griswald - Texas Tech University Health Sciences CenterNatalie Fitzgerald - Richard M. Fairbanks FoundationLucy Wibbenmeyer - University of Iowa Health CareHamed Amani - Lehigh Valley Hospital-PoconoCaryn Cramer - Aastrom BiosciencesWilliam L Hickerson - University of Tennessee Health Science Center
- Resource Type
- Journal article
- Publication Details
- Journal of burn care & research, Vol.45(5), pp.1287-1293
- DOI
- 10.1093/jbcr/irae050
- PMID
- 38502864
- PMCID
- PMC11379135
- NLM abbreviation
- J Burn Care Res
- eISSN
- 1559-0488
- Language
- English
- Electronic publication date
- 03/19/2024
- Academic Unit
- Surgery; Injury Prevention Research Center
- Record Identifier
- 9984573953002771
Metrics
6 Record Views