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[20]
for 73 days until skin was available for grafting . After vascularization, NovoSorb® BTM can be grafted
with sheet grafts, or wide mesh with RECELL® spray. For the burns > 85%-90% TBSA, we will also cover the
[24]
matrix with 6:1 meshed autograft, cultured epithelial autografts, and RECELL® . Our outcomes for the
[25]
massive burn have been decent . While patients survive, scarring is still a major sequela. Many other
papers in this Special Issue will cover the use of the various newly available products.

CONCLUSION
There are many strategies using relatively inexpensive and standard equipment that can optimize outcomes
in burn patients. To optimize re-epithelialization, maintain a moist environment to shorten the time to
wound closure and reduce hypertrophic scarring in partial-thickness burns. Patients can have early excision
and grafting on the day of excision with excellent results. Sheet split-thickness skin grafts always have better
appearances compared to meshed grafts. Thicker grafts contract less than thin ones and should be
prioritized for more cosmetic areas, such as the hands and face. Compromises must be made when dealing
with massive burns, but decent outcomes are possible. As more patients with massive burns survive the
effort, the focus should be on optimizing their cosmetic and functional outcomes.

DECLARATIONS
Authors’ contributions
The author contributed solely to the article.

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
The author declared that there are no conflicts of interest.

Ethical approval and consent to participate
Since this paper does not involve research, institutional review board (IRB) approval is not required by the
institution (Shriners Children’s Northern California). Written consent was obtained for pictures with
identifying features [Figures 5, 11, and 12]. Due to de-identified historical medical records, obtaining
informed consent is not feasible.

Consent for publication
Written consent was obtained for pictures with identifying features [Figures 5, 11, and 12].

Copyright
© The Author(s) 2024.

REFERENCES
1. Deitch EA, Wheelahan TM, Rose MP, Clothier J, Cotter J. Hypertrophic burn scars: analysis of variables. J Trauma 1983;23:895-8.
DOI PubMed
2. Chipp E, Charles L, Thomas C, Whiting K, Moiemen N, Wilson Y. A prospective study of time to healing and hypertrophic scarring in
paediatric burns: every day counts. Burns Trauma 2017;5:3. DOI PubMed PMC
3. Brown GL, Nanney LB, Griffen J, et al. Enhancement of wound healing by topical treatment with epidermal growth factor. N Engl J
Med 1989;321:76-9. DOI PubMed
4. Wardhana A, Valeria M. Efficacy of skin substitutes for management of acute burn cases: a systematic review. Ann Burns Fire
Disasters 2022;35:227-36. PubMed PMC
5. Gibson ALF, Holmes JH 4th, Shupp JW, et al. A phase 3, open-label, controlled, randomized, multicenter trial evaluating the efficacy
and safety of StrataGraft® construct in patients with deep partial-thickness thermal burns. Burns 2021;47:1024-37. DOI PubMed