For extensive burns, autologous donor skin may be insufficient for early debridement and grafting in a single stage. A novel, synthetic polyurethane dermal template (NovoSorb® Biodegradable Temporising Matrix, BTM) was developed to address this need. The aim of this study was to evaluate use of BTM for primary dermal repair after deep burn injury. A multicentre, prospective, clinical study was conducted from September 2015 to May 2018. The primary endpoint was % split skin graft take over applied BTM at 7-10 days after grafting. Secondary endpoints included % BTM take, incidence of infection and adverse events, and scar quality to 12 months after BTM application. Thirty patients were treated with BTM and delayed split skin grafting. The % graft take had a mean of 81.9% and % BTM take had a mean of 88.6%, demonstrating effective integration of BTM. When managed appropriately, it was possible for BTM to integrate successfully despite findings suggestive of infection. Scar quality improved over time. These results provide additional clinical evidence on the safety and performance of BTM as an effective dermal substitute in the treatment of patients with deep burn injuries.

NovoSorb^Ⓡ Biodegradable Temporizing Matrix (BTM) is a relatively novel, biodegradable polyurethane-based dermal regeneration template. The aim of this study was to evaluate the long-term scarring outcomes and safety of BTM in patients who underwent dermal reconstruction involving ≥5% of the total body surface area. This was a postmarket, multicenter, observational cohort study involving evaluation of long-term outcomes in patients treated with BTM. A total of 55 patients (35 from Royal Adelaide Hospital, South Australia, and 20 from Victoria Adult Burns Service, The Alfred, Victoria) who underwent dermal repair with BTM between 2011 and 2017 were screened for inclusion in this study. All patients had BTM implanted for ≥18 months. Fifteen eligible patients with a mean (SD) age of 49.1 (14.3) years completed study assessments. These patients had a total of 39 areas treated with BTM. Using the Patient and Observer Scar Assessment Scale, scar quality was reported to be good by both observers and patients, with a mean (SD) observer score across all lesions of 3.6 (1.2) and mean (SD) overall opinion of 3.8 (1.2) as well as a mean (SD) patient score of 3.5 (1.2) and overall opinion of 5.0 (2.2). No adverse events or adverse device effects were reported or identified. The long-term scar quality is comparable to published studies. BTM is safe in the long term with no additional risks or adverse consequences being identified.

Despite significant advances in recent decades, severe burns remain a formidable challenge, with high morbidity and mortality rates. The immunocompromised state following severe burn injuries, compounded by the loss of the protective skin barrier, increases the risk of bacterial colonization and invasion. Without appropriate management, infections in burn patients can progress to sepsis, a life‐threatening complication. Current burn care often fails to achieve optimal tissue regeneration and infection prevention, necessitating a combination of different approaches. Developing innovative and safer strategies to mitigate burn infections is essential for improving patient outcomes. This review provides updated insights into various biomaterials tailored for managing infections in severe burns, offering comprehensive insights and a summary of emerging technologies for potential clinical application. Additionally, an in‐depth discussion on current research and clinical areas that warrant further investigation is presented. Potential avenues for next‐generation dermal substitutes aimed at improving regeneration and preventing burn wound infections are then explored.

Moisturizing is a widely recommended and accessible approach to scar management, yet objective evidence supporting the efficacy of commonly used products remains limited. Research suggests that moisturizers may reduce hypertrophic scar activity by normalising transepidermal water loss (TEWL) and enhancing skin hydration. This study aimed to provide insights into the effect of generic moisturizers on TEWL and hydration in a scar model, helping clinicians make informed recommendations for scar treatment. The performance of eight moisturizing products were evaluated using a tape-stripping method on normal skin to simulate the elevated TEWL conditions observed in active scars. Thirty participants were recruited based on power calculations, with TEWL and hydration measurements recorded at baseline and hourly for four hours. Untreated tape-stripped areas served as controls for each participant. Eucerin demonstrated the highest efficacy, significantly increasing hydration and normalising TEWL. Sorbolene ranked second, showing notable improvements in both hydration and TEWL regulation. Alhydran produced mixed results, effectively normalizing TEWL but reducing hydration. QV Lotion increased hydration but had minimal impact on TEWL. Aqueous Cream exhibited a non-significant trend toward TEWL normalisation. The silicone gel sheet provided high hydration levels but caused elevated TEWL after removal due to rapid evaporation of retained moisture. Liquid silicone (Strataderm) and BioOil performed poorly, with negligible effects on hydration and TEWL. These findings reveal significant variability in the effectiveness of common scar management products, emphasising the limited utility of liquid silicones compared to basic moisturizers. Products with balanced formulations of humectants, emollients, and occlusives showed objective evidence to indicate efficacy in managing hypertrophic scars during their active phase. This study offers evidence-based guidance for clinicians and highlights the need for further research to optimise formulations for scar management.

Inhalation injury is a major contributor to mortality following burn injury. Despite recognised clinical criteria to guide the intubation of burn patients, concerns remain regarding overutilisation of intubation. Complications can arise as a result of intubation, including ventilator-associated pneumonia (VAP). This study reviews the indications for intubation against the internationally accepted criteria (American Burns Association (ABA) and Denver criteria) for burn patients treated at the Royal Adelaide Hospital (RAH) burns unit between 2017 and 2020. Burn patients who were intubated on arrival to the RAH or in a pre-hospital setting were identified using the BRANZ database. Indications for intubation were compared to the ABA and Denver criteria. A total of 61 patients were identified with a mean total body surface area of 17.8%. A total of 95% of patients met one of the ABA and Denver criteria. The most common ABA and Denver criteria for intubation was deep facial burns or singed facial hair, respectively. Most adult patients with burns admitted to the RAH are intubated per published criteria. Early nasoendoscopy/bronchoscopy may be useful in determining patients who can be safely extubated within 48 h.