Temporary Soft Tissue Coverage in Burn Patients - Which Materials Are Used - and By Whom? Analysis of German Billing Data

OBJECTIVES: Numerous materials are available for temporary soft tissue coverage in burn patients. The German system classifies eight different groups. On the basis of billing data, we analyzed what materials were used preferentially in 2021 and whether age group or gender differences can be found.

METHODS: Evaluation of the billings of all German hospitals about materials of temporary soft tissue coverage exclusively for burn wounds with data from the Institute for the Hospital Remuneration System and the Federal Statistical Office.

RESULTS: In 2021, 12,764 temporary soft tissue covers were coded for burn wounds. Of these, 7,263 (56.9%) in children <18y and 1,446 (11.3%) were in adults >60y. Share of used materials was (in parentheses: In patients <18y and >60y): hydrolytically absorbable membrane 62.0% (63.0%; 53.5%), alloplastic materials 28.5% (30.0%; 31.5%), allogeneic material 4.0% (1.9%; 9.1%), xenogeneic material 3.0% (2.4%; 3.0%), allogeneic skin substitute 1.6% (1.6%; 1.6%); activated keratinocytes 0.0% (0.0%; 0.1%); combination of different materials 0.3% (0.2%; 0.8%); and other materials 0.5% (0.8%; 0.4%).

Average age of the patients was 22.7y (median 10y). For the individual materials, the results were (median in parentheses): Hydrolytically resorbable membrane 21.6y (9y), alloplastic materials 22.3y (6y), allogeneic material 39.8y (42y), xenogeneic material 28.3y (22y), allogeneic skin substitute 22.4y (7y); activated keratinocytes 37.6y (35y); combination of different materials 33.1y (23y); and other materials 11.9y (3y).

Coverages in male patients accounted for 60.6% of all coverages. Males were also preferred in combinations (69.4%) and allogeneic materials (66.6%). Other materials were used preferably in female patients (61.8%).

CONCLUSIONS: Analysis of temporary coverage for burns using billing data is feasible. Half of all such applications were coded in children younger than 10 years in 2021. Hydrolytically absorbable membranes are preferred in all age groups and genders. This analysis can only reflect preferences of practitioners, independent of clinical evidence and efficacy.