Innovative Autologous Coverage for a 90% TBSA Full-Thickness Burns

This young patient of 10 years of age sustained an extensive full-thickness burn injury when his pyjamas caught on fire. He presented with a 90% full-thickness burn and a Grade 2 moderate inhalation injury without any concomitant trauma. Unaffected areas were the right scalp, right upper and mid-face, and feet. The main challenge with this case was autologous coverage. Given the extent to the surface area of the burn, all autologous reconstituted options for coverage were explored in order to expedite definitive coverage. Hence, both ADM with CEA and a bi-layer autologous self-assembled skin substitutes (SASSs) (LOEX Tissue Engineering Laboratory, Quebec City, Canada) were used. The patient survived this massive burn injury with a good quality of life. SASS showed a permanent stable coverage throughout time, and a biopsy done 1 year later showed similar histology to native skin.