(CS-045) Comparative Outcomes of Porcine Urinary Bladder Matrix vs. a ‘Pooled’ Dermal Substitute Cohort in Lower Extremity Partial Thickness Burn Management: A National Retrospective Analysis

Malachy Asuku, MD, FACS, MBA; Yifei Dai, PhD; Bart Phillips, MS; Claire Witherel, PhD

Introduction:

Partial thickness burn management frequently incorporates dermal substitutes, including synthetic membranes and extracellular matrix (ECM)-based products. Porcine urinary bladder matrix (UBM) is a xenograft-derived technology available in micronized and sheet-based format that is has increasingly been utilized in burn care. However, comparative real-world evidence evaluating its performance relative to commonly used dermal substitutes remains limited. This study evaluated national burn registry data to compare clinical outcomes between partial thickness burn patients treated with UBM versus compared to other dermal substitute materials.

Methods:

A retrospective cohort analysis was conducted using data from the American Burn Association’s National Burn Repository (NBR) and Burn Care Quality Platform (BCQP) from 2021–2024. Partial thickness burn patients to the lower extremity and subsequently treated with UBM were identified and compared to a control cohort treated with dermal substitutes, defined as tissue substitute materials including synthetic membranes and non-UBM ECM products. Extracted variables included demographics, comorbidities, burn severity (TBSA), and clinical outcomes. Primary outcomes included length of hospital stay normalized to burn size (LOS/TBSA) and graft loss requiring repeat operative intervention.

Results:

A total of 134 partial thickness lower extremity burn patients treated with UBM were compared with 322 patients treated with dermal substitutes. Patients in the UBM cohort demonstrated a shorter normalized hospital stay, with an average LOS/TBSA of 3.13±5.18 compared with 4.63±7.48 in the dermal substitute cohort; this analysis incorporates all burn severities and is not normalized by other factors that influence length of stay (inhalation injury or mental health status). Additionally, UBM use was associated with a lower incidence of graft loss requiring repeat procedure (2/134, 1.5%) compared with dermal substitutes (24/322, 7.5%).

Discussion:

In this national retrospective analysis of partial thickness burn patients, treatment with UBM was associated with reduced hospital length of stay and lower rates of graft failure compared with a pooled group of dermal substitute materials. These findings suggest that UBM may offer clinical advantages over commonly used dermal substitutes in partial thickness burn management. Further analyses are warranted to evaluate additional outcomes, including time to wound closure, resource utilization, and discharge disposition.