Tissue engineering as a tool in a novel approach to the comprehensive treatment and management of a deeply and extensively burned patient: case report.

Deep and extensive thermal burns with concurrent inhalation injuries can be associated with a high mortality rate, especially among elderly patients. Injuries of this type require treatment in highly. specialized centers. Early excision and autografting are the standard of care for extensive, deep burns. To achieve a functionally and aesthetically satisfactory burn scar, allogeneic acellular dermal matrices (ADMs) can be used as co-grafts alongside autologous split-thickness skin grafts (STSGs). Additionally, the application of in vitro-cultured autologous keratinocytes and fibroblasts has been shown to accelerate burn wound healing. Allogeneic amnion transplantation can also be performed to promote healing at donor sites. This paper presents a case report of a 65 year-old patient with thermal burns covering 26% total body surface area (TBSA) with third-degree burns affecting the thorax, abdomen, back, right shoulder, right elbow, and right thigh, as well as airway involvement. The patient underwent multistage surgical treatment, including deep excision of necrotic tissues. The wound was treated using a combination of ADM, free STSG, in vitro-cultured skin cells, and local negative pressure wound therapy (NPWT). Allogeneic amnion grafts were applied to the donor sites, which were used multiple times after healing. Healing progress was monitored using laser speckle contrast analysis (LASCA). Additionally, scar viscoelasticity, transepidermal water loss, melanin content, epidermal thickness, and temperature were examined post-healing. Selected skin parameters were also assessed using high-frequency ultrasound. The patient was discharged on day 77, having spent 41 days in the surgical ward and 36 days in the rehabilitation ward, with fully healed wounds. It is important to note that rehabilitation began on the first day of hospitalization. Follow-up visits documented gradual improvement in the evaluated scar parameters.