Treatment of deep second-degree burns on the abdomen, thighs, and genitalia treatment: use of tilapia skin as a xenograft

Mr. Editor

I read with great interest the article “Treatment of deep second degree burns in the abdomen, thighs, and genitalia: use of tilapia skin as a xenograft,” published in the Revista Brasileira de Cirurgia Plástica¹. The article describes a clinical case of conservative treatment of a deep second-degree burn with biological dressing. Even aware that part of the collagen in the tilapia skin resides in the recipient bed ², I would like the authors to comment on the following aspects:

1. The use of biological dressings should consider the relationship between risk and benefit; that is, for minor burns, we should prefer alternatives without the possibility of transporting pathogens. Consolidation Ordinance number 4, from the Ministry of Health³, allows, for example, the use of allograft only in patients with at least 40% of the body surface burned.

2. It is known that the treatment of 2nd-degree deep burns is tangential debridement until tissue viability is met, and autologous skin grafting⁴. Deep 2nd-degree burns treated conservatively will result in great healing and posterior contraction, with significant aesthetic and functional damage. I would like the outcome after one year of treatment of the case in question to be published.

Finally, I would like to declare my great admiration for the work of Dr. Edmar Maciel Lima Júnior’s team about the use of tilapia skin to treat large superficial 2nd-degree burns.

REFERÊNCIAS

• ¹
  Lima Júnior EM, Moraes MO, Costa BA, Uchôa AMN, Martins CB, Moraes MEA, et al. Tratamento de queimaduras de segundo grau profundo em abdômen, coxas e genitália: uso de pele de tilápia como um xenoenxerto. Rev Bras Cir Plást. 2020;35(2):243-8.
• ²
  Bezerra LRPS, Moraes Filho MO, Bruno ZV, Lima Júnior EM, Alves APNN, Bilhar APM, et al. Tilapia skin fish: a new biological graft in gynecology. Rev Med UFC. 2018 Jun;58(2):6-8.
• ³
  Ministério da Saúde (BR). Portaria de Consolidação no 4, de 28 de setembro de 2017. Consolidação das normas sobre os sistemas e os subsistemas do Sistema Único de Saúde [Internet]. Brasília (DF): Ministério da Saúde; 2017; [citado 2020 Ago 13]. Disponível em: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2017/prc0004_03_10_2017.html
  » http://bvsms.saude.gov.br/bvs/saudelegis/gm/2017/prc0004_03_10_2017.html
• ⁴
  Liu HF, Zhang F, Lineaweaver WC. History and advancement of burn treatments. Ann Plast Surg. 2017 Fev;78(Supl 1):S2-S8.

Publication Dates

• Publication in this collection
  02 June 2023
• Date of issue
  2020

History

• Received
  13 Aug 2020
• Accepted
  10 Nov 2020