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Purpose Therapeutic success of surgical interventions is significantly affected by patients’ adherence. Patient autonomy can lead to unreasonable behavior. We analyzed the consequences and predisposing factors of patient self-discharge in a plastic and hand surgery cohort. Study design and setting Data was collected retrospectively in a case–control study with n = 73 patients who had self-discharged in a 10-year time period and n = 130 controls (discharge by the surgeon). Data was collected through the hospital information systems and a particular questionnaire. Statistical analyses were performed via chi-squared test and logistic regression analyses. Results Patients who self-discharged against medical advice had a significantly higher complication rate (p = 0.045) and a higher number of revision operations (p p p = 0.002; OR 5.387 (1.734–16.732)) or had to take care of their children at home (p = 0.006; OR 1.481 (1.280–1.741)). There was a significantly lower pain score (NAS) on time of self-discharge (p = 0.002) as well as 24 h after self-discharge (p Conclusion Self-discharge was associated with predisposing factors and poorer outcomes. Patient autonomy can lead to health-compromising behavior and patients should be counseled accordingly.

The enlarged nipple-areola-complex (NAC) is a characterizing aspect of gynecomastia. The purpose of this study was to multidimensionally quantify the reduction of the NAC after a subcutaneous mastectomy (SCM) with or without ultrasound-assisted liposuction (UAL). A retrospective assessment of patients who underwent SCM +/- UAL due to gynecomastia over a period of 11 years was conducted. The NAC diameters were measured before and after surgery. In addition, a survey (including the BREAST-Q) regarding patient-oriented outcome was performed. The study cohort consisted of 55 men and resulting 105 NACs (SCM n=63, SCM+UAL n=42). It could be shown that the reduction of the NAC considering all parameters (horizontal and vertical diameter and the area) was significantly larger (p=

Background AirSeal® is a valve-free insufflation system that enables a stable pneumoperitoneum with continuous smoke evacuation and CO2 recirculation during laparoscopic surgery. Comparative evidence on the use of AirSeal® and standard CO2 insufflator in laparoscopic general surgery procedures is scarce. The aim of this study was to compare surgical outcomes between AirSeal® and standard CO2 insufflators in patients undergoing the most frequently performed laparoscopic procedures. Methods One hundred and ninety-eight patients undergoing elective laparoscopic cholecystectomy, colorectal surgery and hernia repair were randomized to either AirSeal® (group A) or standard pressure CO2 insufflator (group S). The primary endpoints were operative time and level of postoperative shoulder tip pain (Visual Analog Scale). Secondary outcomes included Clavien–Dindo grade complications, surgical side effect and length of hospital stay. Results Patients were randomized to either group A (n = 101) or group S (n = 97) and were analyzed by intention-to-treat. There was no significant difference in mean operative time between the groups (median [IQR]; 71 min [56–94] in group A vs. 69 min [52–93] in group S; p = 0.434). Shoulder tip pain levels were significantly lower in group S (VAS 0 [0–3] in group S vs. 2 [0–4] in group A; p = 0.001). There was no significant difference in complications, surgical side effects (subcutaneous emphysema was not observed in any group) and length of hospital stay. Conclusion This randomized controlled trial showed that using the AirSeal® system did not reduce operative time and was associated with a higher postoperative shoulder tip pain compared to standard CO2 insufflator for short elective surgeries. ClinicalTrials.gov (NCT01740011).

Zusammenfassung Hintergrund Die aktuellen Richtlinien für Verletzungen durch Tierbisse empfehlen chirurgisches Debridement und Antibiotikatherapie. Im Allgemeinen führen Bisswunden zu Infektionen mit einem sehr hohen Risiko durch tief eindringende Hautläsionen. Bisswunden können sich jedoch durch die Eindringtiefe und die Beteiligung verschiedener anatomischer Strukturen drastisch unterscheiden. Eine prognostische Klassifikation über die Tiefe oder Schwere gibt es nur für Gesichtsverletzungen bei pädiatrischen Patienten – das ist der Score von Lackmann. In dieser Studie wurden prognostische Faktoren bewertet und ein prospektiver Score für allgemeine Tierbissverletzungen entwickelt. Patienten und Methoden Eine retrospektive Einzelzentrumsanalyse wurde bei Verletzungen von Tierbissen zwischen 2007 und 2017 durchgeführt. Die Patienten wurden nach Tierart, Bissort, Behandlungsart und medizinischer Versorgung, Aufnahme, Verweildauer, Revisionsbedarf und Keimspektrum unterteilt. Es wurde ein Bewertungs-Score ermittelt und verifiziert, der von Grad I (oberflächlicher Kratzer) bis Grad Va (tiefe Wunde mit Knochenbeteiligung) und Grad Vb (tiefe Wunde mit Gelenkbeteiligung) reicht. Ergebnisse 567 Patienten mit Tierbiss-Verletzungen wurden eingeschlossen, von denen 51,7 % von Hunden, 39,2 % von Katzen und 4,1 % von Wildtieren verursacht wurden. 75,7 % der Verletzungen befanden sich an den Händen, 12,9 % an den Armen, 5,1 % im Gesicht und 5,3 % an anderen Stellen. Der häufigste Keim war Pasteurella, gefolgt von Staphylokokken und anderen aeroben Arten. Die antibiotische Behandlung umfasste in 75 % der Fälle Sultamicillin, Cephalosporine in 10,2 %, Clindamycin in 7,6 % und andere Antibiotika in 5,1 %.Es wurde eine signifikante Korrelation (p < 0,001) zwischen der Tierart und dem Vorliegen einer Infektion, der Art der medizinischen Versorgung, dem Bewertungs-Score und dem Keimspektrum festgestellt, ebenso wie zwischen dem Bewertungs-Score und der Notwendigkeit einer Revision, der Dauer der Antibiotikatherapie, der Art der Aufnahme, der Behandlung und der medizinischen Versorgung sowie der Dauer des Krankenhausaufenthaltes. Schlussfolgerung Der prognostische Wert des ermittelten Bewertungs-Scores konnte verifiziert werden. Darüber hinaus wurde die Bedeutung der Tierarten für die Behandlung aufgezeigt. Sultamicillin mit einer Wirksamkeit gegen die meisten der identifizierten Keime sollte als ermittelte Erstlinien-Antibiotikatherapie verwendet werden.

Zusammenfassung Ziel Diese Studie untersucht, inwieweit der Vorstellungszeitpunkt bei vorliegender Handinfektion (HI) mit der stationären Liegedauer sowie der Häufigkeit notwendiger Operationen der Patienten korreliert. Patienten und Methoden Retrospektiv wurden die stationären Krankenakten von 379 Patienten mit HI, die zwischen 2007 und 2014 an unserer Klinik (2007–2014) behandelt wurden, statistisch hinsichtlich eines Zusammenhangs zwischen Vorstellungszeitpunkt und Liegedauer sowie der Häufigkeit notwendiger Operationen ausgewertet, wobei auch die Infektionsursache Berücksichtigung fand. Ergebnisse Im Durchschnitt führte eine um mehr als einen Tag verzögerte fachchirurgische Vorstellung zu einer längeren Krankenhausverweildauer von 1,22 Tage (KHVD) (95 %-KI: 1,20–1,25; p < 0,001). Die Notwendigkeit einer operativen Intervention nahm mit jedem Tag Verzögerung um 13,59 % (95 %-KI 4,01 %–25,43 %; p < 0,001) zu. Der verzögerte Beginn einer Antibiotikagabe führte zur Verlängerung der KHVD um den Faktor 1,09 (95 %-KI: 1,03–1,15; p < 0,001), wobei jedoch keine Korrelation bestand zwischen Zeitpunkt der Antibiotikagabe und der Notwendigkeit zur operativen Revision (ja/nein) (p = 0,11). Schlussfolgerung Eine verspätete Vorstellung von Patienten mit Handinfektionen führt zu einer längeren stationären Aufenthaltsdauer sowie zu einer höheren Anzahl an notwendigen Operationen. Eine frühzeitige Vorstellung von HI beim Handchirurgen ist wichtig, um komplizierte Krankheitsverläufe und unnötige Kosten für das Gesundheitssystem zu vermeiden.

Background: Hand infections can spread quickly and destroy functional structures. Early diagnosis and adequate therapy can prevent severe morbidities. The aim of this study was to evaluate systematically the spread of hand infections according to injury mechanism, pathogens, and entry site. Methods: The data and medical records of 425 patients were collected and analyzed retrospectively. Results: The entry site had a significant influence on the severity of hand infections. Especially finger lesions led to severe infections. Furthermore, a high C-reactive protein (CRP) concentration correlated with more involved compartments of the hand. Bacterial counts also correlated with the number of compartments involved. Conclusions: Compared with known factors for the severity of hand infections finger lesions lead to especially severe infections and should not be underestimated. If there is a higher CRP concentration or more than one bacterial species isolated, compartments adjacent to the site of injury should be checked intra-operatively.

Background: Ligament suspension after trapeziectomy is a common technique in patients with osteoarthrosis. In this study, we set out to determine whether the orientation of the bone tunnel in the first metacarpal base affects the intraoperative position of the first metacarpal after surgery. Methods: Trapeziectomy and Epping procedure were performed in 32 cadaver hands. A drill hole was placed in the base of the first metacarpal, leaving a radial to ulnar tunnel parallel to the joint surface or a diagonal bone tunnel from the radiodorsal surface to the ulnar joint surface of the first metacarpal. Positioning of the first metacarpal was studied via radiography. Results: The distance between the first metacarpal and the scaphoid after suspension arthroplasty was 9.5 ± 2.6 mm when using the parallel radioulnar bone tunnel and 10.9 ± 2.3 mm when using the diagonal bone tunnel. Suspension of the first metacarpal was 33% higher with the diagonal bone tunnel compared with when using the parallel bone tunnel (displacement of 2.8 ± 2.0 mm vs 4.2 ± 2.0 mm). Conclusions: Higher suspension of the first metacarpal after trapeziectomy can be significantly achieved in our cadaveric model when using ligament suspension of the flexor carpi radialis tendon passed from the ulnar joint surface to the dorsum of the metacarpal. Our results have to be determined via clinical examination. To date, we prefer the diagonal bone tunnel when performing ligament suspension arthroplasty.

Zusammenfassung Hintergrund Im beruflichen und privaten Bereich ist Zement nach wie vor ein häufig verwendetes Baumaterial. In unseren Kliniken stellen sich immer wieder Patienten mit Verätzungen nach Betonexposition vor. Unser Ziel war es unsere gesammelten Fälle zu analysieren und Empfehlungen zur Behandlung bei Exposition und deren Folgen zu geben. Patienten und Methoden Im Zeitraum von 2013–2017 wurden in zwei deutschen plastisch-chirurgischen Kliniken insgesamt 7 Patienten, welch nach Beton-, Zement- oder Estrich-Exposition Verätzungen in unterschiedlichen Körperregionen entwickelten, behandelt. Hierbei erfolgte im Verlauf eine systematische retrospektive Analyse der Patientendaten. Ergebnisse Bei allen Fällen war eine chirurgische Behandlung erforderlich. Die mittlere stationäre Behandlungsdauer betrug 9,8 Tage (n = 6). Die durchschnittliche Operationsdauer für eine Spalthautdefektdeckung belief sich auf 1:04 Stunden (n = 5). Es wurden im Rahmen der chirurgischen Behandlung im Durchschnitt 1,4 Operationen durchgeführt (n = 7). In allen Fällen erfolgte eine nachhaltige Wundheilung. Schlussfolgerung Bei Betonverätzungen ist eine schnelle und kompetente Erstbehandlung erforderlich, um einem Nachtiefen in den exponierten Arealen erfolgreich entgegenwirken zu können. Diese chirurgisch therapiebedürftigen seltenen Verätzungsverletzungen sollten demnach nur in speziellen Verbrennungskliniken therapiert werden.

Hintergrund: Vermeintlich als Notfall deklarierte Handverletzungen binden in nicht unerheblichem Ausmaße personelle und strukturelle Kapazitäten in der Notfallversorgung. Auch für das Fach der Plastischen Chirurgie wird eine mehrheitlich unberechtigte Notfall-Vorstellung vermutet. Mit[zum vollständigen Text gelangen Sie über die oben angegebene URL], 49. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 23. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

Backround The aim of this study was to determine, if Wide Awake Local Anesthesia No Tourniquet (WALANT) can be used as an alternative method of providing anesthesia in management of deep infections of the hand. Since the advent of WALANT in 2003, infections of the hand have been regarded as a contraindication to its use. Occasional shortage of anesthesiologic manpower, especially during busy call hours and the current COVID-19 pandemic can lead to delay of treatment where urgent surgery is needed, to prevent progress of an infection, that can result in severe morbidity. Methods In the period from 2015 to 2020, 16 patients with various infections of the hand underwent 17 operations using WALANT in a Hand Trauma and Replantation Center (HTRC) in Germany. Retrospective cohort analysis of their operation reports, with emphasis on location of infection, time and duration of the operation, intraoperative incidents and complications were carried out. We also evaluated the need for revision surgery or necessity to convert to general anesthesia and factors causing delay till the time of surgery. Results No case of inadequate analgesia, the need to convert to general anesthesia, ischemic events or cardiovascular complications with the use of the WALANT solution containing adrenaline and lidocaine in the treatment of deep tissue infections. The highest priority of limb preservation was ensured as no patient progressed to amputation of a digit or the hand. There was a statistically significant difference (p≤0.01) in delay from the time of admission until surgery of up to 9h24 m (SD±3h34 m) during the week and 4h10 m (SD±2h28 m) during the weekend. Conclusion The status of infection as an absolute contraindication to the use of WALANT should be revised. Especially when human resources are limited, WALANT is an adequate technique to enable quick anesthesia for urgent treatment to prevent progression of hand infections., Highlights • Wide Awake Local Anesthesia No Tourniquet can be used to treat deep hand infections. • In the COVID-19 pandemic alternative ways of providing anesthesia are needed. • Absolute contraindication to the use of WALANT should be reevaluated. • “time is function”, urgent treatment remains key in management of hand infections.

Zusammenfassung Problemstellung Die zunehmende Verwendung von autologen Fetttransplantationen veranlasste 2009 die American Society of Plastic Surgeons eine Fat Graft Task Force (AFGT) zu etablieren und in 2015 die Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC) gemeinsam mit drei weiteren Fachgesellschaften (DDG, DGMKG, DGGG) an Hand der bislang publizierten Ergebnissen Behandlungsleitlinien zu erstellen. Die vorliegende Arbeit will die beiden Leitlinien hinsichtlich Ihres Anliegens, einer sicheren Durchführung von autologer Fetttransplantation, vergleichen. Methoden Die AFGT stützt ihre Empfehlungen ausschließlich auf Parameter der evidenzbasierten Medizin. Die DGPRÄC bewertet unter Berücksichtigung der aktuellen Literatur im Rahmen eines vierstufigen Expertenkonsenses das Vorgehen nach allgemeinen Anforderungen der Operativen Medizin und gesetzlichen Vorgaben. Ergebnisse Beide Gesellschaften stimmen in Indikation und technischen Vorgehen weitestgehend überein: Fetttransplantationen sind indiziert zum Brustaufbau, zur Rekonstruktion von Gewebsdefiziten oder Deformitäten. Beide weisen auf die Risikogruppe bestimmter Brusttumoren (BRCA-1, BRCA-2) bzw. familiäre Prädispositionen hin. In fast allen Anwendungsbereichen sind Ergebnisse abhängig von der verwendeten Applikationstechnik und den Erfahrungen eines Operateurs. Randomisierte, prospektive Studien für bestimmte Verfahren fehlen. Aufgrund der Einzelberichte und Expertenmeinungen liegt zwar nur eine Evidenz-Stufe von IV–V nach Einschätzung der AFGT vor. Demgegenüber vermittelt die DGPRÄC detailliertere Vorgehensverfahren und erreicht durch das Experten-Konsensusverfahren eine deutlich stärkere Aussagefähigkeit als die Leitlinie der AFGT. Zusammenfassung Beide Expertengremien empfehlen die Durchführung autologer Fetttransplantationen bei entsprechenden Indikationen und weisen darauf hin, dass es keine Standardverfahren für ein bestimmtes Vorgehen gibt. Die publizierten Leitlinien sollen Hinweise geben auf die richtige Patientenselektion, eine optimale Technik, mögliche Komplikationen und realistische Erfolgsaussichten. Die DGPRÄC empfiehlt die Einhaltung der von ihr gegebenen praktischen Einzelrichtlinien einschließlich der gesetzlichen Vorgaben, um die Patientensicherheit zu gewährleisten und ist damit in der Praxis richtungsweisender und verbindlicher. Die AFGT rät dringend zur erweiterten Grundlagenforschung und zur Durchführung randomisierter, prospektiver Studien.

Objectives/Interrogation: Comparison of SCAphoid fracture osteosynthesis by MAGnesium-based headless Herbert screws with titanium Herbert screws: protocol for the randomized controlled SCAMAG clinical trial Methods: The trial is designed as a multicenter, blinded observer, randomized controlled[for full text, please go to the a.m. URL], 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

Background End-to-end and end-to-side anastomoses remain the most common techniques in microsurgical free flap reconstruction. Still, there is an ongoing effort to optimize established techniques and develop novel techniques. Numerous comparative studies have investigated flow dynamics and patency rates of microvascular anastomoses and their impact on flap survival. In contrast, few studies have investigated whether the type of anastomosis influences the outcome of microvascular free flap reconstruction of a lower extremity. Patients and Methods Retrospectively, we investigated the outcome of 131 consecutive free flaps for lower extremity reconstruction related to the anastomotic technique. Results No statistical significance between arterial or venous anastomoses were found regarding the anastomotic techniques (p = 0.5470). However, evaluated separately by vessel type, a trend toward statistical significance for anastomotic technique was observed in the arterial (p = 0.0690) and venous (p = 0.1700) vessels. No thromboses were found in arterial end-to-end anastomoses and venous end-to-side anastomoses. More venous (n = 18) than arterial thromboses (n = 9) occurred in primary anastomoses undergoing microsurgical free flap reconstruction (p = 0.0098). Flap survival rate was 97.37% in the end-to-end arterial group versus 86.36% in the end-to-side group. No thromboses were found in five arterial anastomoses using T-patch technique. Conclusion For lower extremities, there is a connate higher risk for venous thrombosis in anastomotic regions compared with arterial thrombosis. We observed divergent rates for thromboses between end-to-end and end-to-side anastomoses.However, if thrombotic events are explained by anastomotic technique and vessel type, the latter carries more importance.

Booby traps and gun-like devices for vole control can lead to complex trauma requiring emergency medical care. We present a case series of patients who suffered severe hand and facial trauma through detonation of booby traps and paraphernalia (n = 9, O 60 years of age). All patients were admitted to the emergency department of Hannover Medical School for primary care. Between 2011 and 2015 we treated six patients with hand trauma due to gun-like devices, two patients with hand trauma due to booby traps, and one patient with injury to the face including eyes due to a gas cartridge explosion. All hand trauma patients (n = 8) showed injuries of the soft tissue. Six of these patients also presented fractures or lesions of capsular or tendon structures. Therapies included debridement as well as skin grafts or flaps for tissue defect coverage. We informed the Department for Commercial Safety (Gewerbeaufsicht Hannover) in 2014 because we believe that these traps pose a serious safety hazard.

Introduction:Severe hand trauma, leading to extensive skeletal and tissue defects, requires plastic surgical reconstruction of the highest level aiming at maximizing function and aesthetics. The intention of this study was to investigate clinical parameters and resource consumption connected with severe hand injuries, with specific emphasis on a follow-up evaluation of quality of life after the reconstruction process.Materials and methods:In this retrospective study, we evaluated patients with severe hand injuries from 2013 to 2016 who had completed surgical and non-surgical treatment. Measures included total period of therapy (TPT) in days, total duration of operations including anesthesia (TOA), total duration of all operations (TO), and total number of operations (TNO). We also determined total inpatient stay (TIS), total number of clinic presentations with interventions (TNPI), initial hand injury severity score (iHISS), and inpatient proceeds (IPP) in Euros (€). Correlation was assessed between iHISS and TOA, TNO, and TIS. Finally, these patients were reexamined in a follow-up inquiry and the life quality was assessed with the five-level version of the EuroQol five-dimensional (EQ-5D) descriptive system (EQ-5D-5L).Results:We analyzed 12 patients with an average age of 44 years (min. 24 years, max. 75 years). Patients receiving reconstructive surgery experienced median (${\rm{\tilde x}}$) TPT of 175 days [interquartile range (IQR), 51–499], TOA of 13 h (IQR, 6–37), TO of 9 h (IQR, 4–25), and TNO of 5 (IQR, 3–11). Further, the patients’ median TIS was 22 days (IQR, 9–86), TNPI was 4 (IQR, 2–8), and iHISS was 77 (IQR, 44–162). The median IPP was 14.595 € (IQR, 5.541–33.709 €). IHISS was positively correlated with Pearson’s r for TIS (0.817), TOA (0.857), and TNO (0.871). The EQ-5D-5L index value resulted in a high level of life quality with a median of 0.898 (min. 0.8, max. 1).Conclusion:Severe hand injuries are related to high efforts for surgical and functional reconstructions, which result in high quality of life measured with the EQ-5D-5L assessment. However, for a defined collective of patients, myoelectric prosthetic functional replacement should be considered. Further studies are necessary to examine functional outcomes and quality of life after bionic prosthetic replacement. Also, a bionic reconstruction score to define hard criteria for taking an acute treatment decision is necessary.

Introduction. Acellular dermal matrices (ADMs) are now commonly used for breast reconstruction surgery. There are various products available: ADMs derived from human (HADM), porcine (PADM), or bovine (BADM) sources. Detailed long-term follow-up studies are necessary to detect differences in complication rates between these products. Material and Methods. From 2010 to 2015, forty-one patients underwent 52 ADM-breast reconstructions in our clinic, including oncologic breast reconstructions and breast augmentation revisions (n=52). 15x HADMs (Epiflex®/DIZG), 21x PADMs (Strattice®/LifeCell), and 16x BADMs (Tutomesh®/RTI Surgical) were implanted. Retrospective data collection with median follow-up of 36 months (range: 12–54 months) was performed. Results. Overall complication rate was 17% after ADM implantation (HADM: 7%; PADM: 14%; BADM: 31%). In a composite endpoint of complications and Red Breast Syndrome, a lower event probability was observed between BADMs, PADMs, and HADMs (44%, 19%, and 7%, resp.; p=0.01 for the trend). Furthermore, capsular contracture occurred in 6%, more frequently as compared to the current literature. Conclusions. When ADM-based reconstruction is indicated, the authors suggest primarily the use of HADMs and secondary the use of PADMs. It is shown that BADMs have the highest complication probability within our patient cohort; nevertheless, BADMs convey physical advantages in terms of flexibility and better aesthetic outcomes. The indication for the use of ADMs should be filled for each case individually.

Background In Dupuytren's disease (DD), limited fasciectomy is the mainstay of surgical therapy in patients at risk of contractures and disease recurrences. New minimally invasive treatments such as injection of collagenase clostridium histolyticum have evolved as a common tool for the preliminary treatment of Dupuytren's contractures. However, recurrences and their therapy remain controversial. In this study, we evaluate the benefit of repeated limited fasciectomy in patients with aggressive forms of the disease and multiple recurrences of contractures. Methods We evaluated the outcome of 16 patients undergoing limited fasciectomy 3 or more times on a single hand. Results Postoperatively, 10 of 13 (76.9%) patients were satisfied with the clinical result after the last operation; 10 of 12 (83.3%) patients would choose to have their surgery repeated, if so needed. The mean improvement of proximal interphalangeal joint range of motion was 59.2 degrees (SD 26.8) and 86.2% (SD 19.9). There were no severe complications after treatment within the observed time period. Conclusions Our findings demonstrate that patients with recurrence of contractures after multiple previous treatments in aggressive forms of DD can benefit from surgical intervention. In conclusion, repeated limited fasciectomy remains indicated in patients after previous surgeries with DD.

Background Limited data is available for treatment of scald lesions in adults. The use of the biosynthetic matrix Biobrane ® has been suggested as treatment option with more benefits over topical dressings. Application of Biobrane ® in scalds in our center led to a perceived increase of infection, secondary deepening, surgery and length of stay. We therefore assessed the effect of different treatment options in adult scalds in our center. Methods We performed a retrospective cohort study of adult patients that have been admitted with scalds in our center between 2011 and 2014. We assessed two groups, group 1 with Biobrane ® as initial treatment and group 2 with topical treatment using polyhexanid hydrogel and fatty gauze. Primary outcome variables were rate of secondary deepening, surgery, infection (defined as positive microbiological swabs and antibiotic treatment) and length of stay. Total body surface area (TBSA) as well as diabetes mellitus (DM), hypertension, smoking and alcohol consumption as potential confounders were included. Results A total of 52 patients were included in this study. 36 patients received treatment with Biobrane ® and 16 with ointment and fatty gauze. No significant differences were found for age and TBSA whereas gender ratio was different (25/11 male/female in group 1 vs 4/12 in group 2, p = 0.003). Rate of secondary deepening, surgery, infection as well as days of hospital stay (DOHS) were comparable. Logistic and multilinear regression showed TBSA to be a predictive factor for infection ( p = 0.041), and TBSA and age for length of stay (age p = 0.036; TBSA p = 0.042) in group 1. Conclusion The use of Biobrane ® in adult scald lesions is safe and non-inferior to topical treatment options. In elder patients and larger TBSA Biobrane ® may increase the risk of infection or a prolonged stay in hospital. Level of evidence Level 3 – retrospective cohort study.