Re-Epithelialization of Donor Sites and Meshed Skin Grafts Using Cryopreserved Cultured Cutaneous Allograft (Epifast®): Experience in Patients with Extensive Burns

Vollständiger Abstract

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Extensive full-thickness burns remain a major challenge in reconstructive surgery because limited donor-site availability frequently delays definitive wound coverage and increases the risk of infection, prolonged hospitalization, and hypertrophic scarring. Cryopreserved cultured cutaneous allografts have emerged as temporary biological dressings capable of promoting wound healing and accelerating re-epithelialization. This study aimed to evaluate the re-epithelialization time of donor sites and meshed split-thickness skin grafts covered with cryopreserved cultured cutaneous allograft (Epifast®) in patients with extensive full-thickness burns undergoing surgical treatment, as well as to determine the incidence of infection and graft loss. A retrospective observational study was conducted including 53 patients treated at the Burn Unit of the general hospital All patients underwent early excision followed by split-thickness autologous skin grafting, with Epifast® applied to donor sites and meshed grafts. Donor sites were located in the extremities in 82% of patients and in the trunk in 18%. Mean donor-site re-epithelialization time was 7.32 ± 0.13 days for the extremities and 8.04 ± 0.54 days for the trunk. Meshed skin graft re-epithelialization averaged 9.03 ± 2.30 days for a 1:1.5 expansion ratio, 10.50 ± 1.69 days for a 1:3 ratio, and 13.40 ± 2.00 days for a 1:6 ratio. Partial graft loss occurred in four patients, while two developed wound infections. No adverse events directly related to the cryopreserved cultured cutaneous allograft were observed. These findings suggest that Epifast® is a safe and effective temporary biological dressing that promotes rapid re-epithelialization of donor sites and meshed split-thickness skin grafts, facilitates earlier donor-site reutilization, and represents a valuable adjunct in the reconstructive management of patients with extensive full-thickness burns.