SUPRATHEL U ~ ROW
WELCOME TO SUPRATHEL U
Welcome to the SUPRATHEL U training platform – created by experts for experts. Have fun exploring the product SUPRATHEL®, its use and application. Please feel free to contact our experts by phone or email with any questions.
SUPRATHEL® is a Class III medical device distributed in 36 countries across five continents. To date, more than 20,000 patients have been successfully treated in over 300 burn centers. SUPRATHEL® is based on polylactic acid and as an elastic membrane it mimics the natural skin. While being permeable to oxygen and water vapor, it provides a physical barrier for microorganisms.
SUPRATHEL® is indicated in superficial (2a°) and deep dermal/partial thickness (2b°) skin loss diseases, with small full thickness (3°), such as burn wounds, split-thickness skin graft (STSG) donor sites, large scale abrasions, reconstructive surgery, scar corrections, dermabrasio as well as trauma and surgical wounds. To learn more about the product please go to her www.suprathel.com or contact our experts.
Benefits of using SUPRATHEL®
Several advantages support the use and application of SUPRATHEL®
Significant pain relief1-3 – by up to 60%
Significantly less IV narcotic management required
Minimally manipulative dressing changes without anesthesia
Low rate of infections, no biologic risk3-5
Synthetic, biocompatible, absorbable
No reported allergic reactions, only few cases with infections and inflammation
Fast wound healing1,6,7,10
Improved early epithelization
Early mobilization can begin 2-5 days following application
Lower treatment costs2,4,5 – by up to 69%
One-time wound dressing, no change of SUPRATHEL® needed
Less care and aftercare needed, shortened need for hospitalization
Less administration of pain medication needed
Good cosmetic and functional outcomes and scar quality8,9
Reduced systemic inflammatory reaction10,11
1 Uhlig et al. 2007: Burns. 33(2):221-9
2 Schwarze et al. 2007: Burns. 33(7):850-4
3 Schwarze et al. 2008: Ann Plast Surg. 60(2):181-5
4 Everett et al. 2015: J Wound Care. 24(7):S4-8
5 Glat et al. 2014: Abstract, 46th Annual Meeting of the ABA
6 Lindford et al. 2011: Burns. 37(7):e67-72
7 O´Brian et al. 2015: Abstract, 47th Annual Meeting of the ABA
8 Kaartinen and Kuokkanen 2011: J Plast Surg Hand Surg. 45(4-5):200-3
9 Keck et al. 2012: Burns.38(3):388-95.
10 Gürünlüoglu et al. 2019: J Burn Care Res, Jun 21;40(4):444-450
11 Demircan and Gürünlüoglu 2019: Abstract, 51th Annual Meeting ABA
SUPRATHEL® is indicated for superficial and deep dermal/partial thickness 2nd degree skin loss diseases, even with small full thickness (3°) areas (see white line in the burn classification for SUPRATHEL® indications).
Second Degree Burns
Superficial Partial Thickness Burn (degree 2a)
2a degree burn with formation of blister on a child’s foot
- Blisters can be present
- Involvement of the entire epidermis and upperlayers of the dermis layers of the dermis
- Wound color will be pink or red
- Painful and appearing wet / appears wet
- Wound will blanch when pressure is applied
Second Degree Burns
Deep Partial Thickness Burn (degree 2b)
Mixed burns of degree 2a and 2b, right hand after an electric burn injury 1 day after debridement
- Wound may be red or white in color, appears dry
- Blister formation may occur
- Destruction of the entire epidermis and part of the dermis
- Blanching is sluggish or absent
- Sensation may be present, but diminished
Case Study 1 (PDF)
Full Thickness (degree 3)
Mixed burns of degree 2a and 2b, small parts 3°, right hand after an electric burn injury, day of trauma
Split Skin Graft Donor Site
Extensive Skin Abrasion
In particular, SUPRATHEL® has been successfully used in so called “burn-like syndromes.” This describes the wide range of diseases manifested by extensive epidermal blistering and sloughing, as well as cutaneous necrosis requiring hospitalization and special intensive care management. Case Study 3 (PDF) TEN (Toxic Epidermal Necrolysis) (PDF)
Skin lesions degree 2a, 80% BSA
6.1. Wounds caused by TEN (toxic epidermal necrolysis)
TEN (toxic epidermal necrolysis) is diagnosed in patients with an extensive loss of epidermis due to necrosis and a scalded-like appearance of the skin. TEN is the most serious drug-related skin eruption with a mortality rate between 11 and 70%. Patients with less than 10% of epidermal detachment are classified as having Stevens-Johnson Syndrome, while those with more than 30% of TBSA involvement are classified as having TEN.
6.2. EB (Epidermolysis bullosa)
EB (Epidermolysis bullosa) is a genetic defect and not a disease. There are a few case reports in which SUPRATHEL® was used. The primary advantage for this indication is faster wound healing.
SUPRATHEL® -assisted surgical treatment of the hand in epidermolysis bullosa patient (PDF)
6.3. SSSS (Staphylococcal Scalded Skin Syndrome)
SSSS is caused by infection with certain strains of staphylococcus bacteria resulting in skin damage with blisters, as if the skin were scalded.
An innovative local treatment for staphylococcal scalded skin syndrome (PDF)
Dystrophic EB with flexion contractures of all fingers, adduction contracture of thumb, pseudosyndactyly, mitten-like deformity and blisters
Application of SUPRATHEL on a forefoot’s frostbite. Courtesy of Dr. M. Rapp, Stuttgart
SUPRATHEL® used in combination with
7.1. Autologous grafts
SUPRATHEL® can also be ideally combined with autologous grafts, e.g. on top of expanded mesh grafts.
7.2. VAC® (Vacuum Assisted Closure)
SUPRATHEL® may also be applied together with VAC®
In general, SUPRATHEL® can be applied to any body area in children as well as in adults. Due to its plasticity, it can be moulded and is especially suitable for difficult-to-treat areas such as the face, neck, hands and joints. In case of a reduced or even missing availability of split skin grafts, SUPRATHEL® is ideal to bridge the time gap until availability meanwhile reducing the area that needs coverage by split-skin grafts. Large affected areas can thus be temporarily covered reducing the risk of infections while providing immediate pain relief.
As a basic rule, if the total body surface area (TBSA) is below 5% and pain management is the most important in the treatment plan, SUPRATHEL® should be the first choice.
In children, all body parts can be covered with SUPRATHEL®. Even if the deep dermis is partially affected, SUPRATHEL® functions as a temporary skin substitute and does not integrate into the skin.
- Infected wounds
- Exposed tendon / bone / cartilage / muscle
- Necrotic wound area
- Old burn wounds
- Heavily exuding wounds
How to avoid common mistakes
Insufficient debridement: consider surgical (sharp) debridement in deeper wounds. SUPRATHEL® applied too early after trauma: wait for 24 hours after trauma in case of deeper wounds. Consider Lavasept® / Hibiclens® dressing after debridement. Insufficient hemostasis: Use 1% adrenaline and warm towels. Consider light compression dressing during the first 1-3 days. Some users utilize stripes or staples around the edges to fixate SUPRATHEL®.
Overlap of membranes should be 2-5 inches (the fatty gauze must be clearly larger than SUPRATHEL®).
Avoid stretching the membrane when applying.
1-2 layers of fatty gauze should do.
Be patient! Leave on wound. SUPRATHEL® – will peel off – after epithelialization. Just change outer dressing.
Change to dry gloves before application.
Avoid any heat sources (e.g. lamps) before application. The thin membrane gets warm quickly.
Be patient! Leave on wound. SUPRATHEL® will peel off after epithelialization. Just change outer dressing.
At first, thorough disinfection and debridement. Then administer a local or systemic antibiotic. Local application of a disinfectant on SUPRATHEL® and monitoring of the inflammatory process secured by transparency of SUPRATHEL® and fatty gauze.
After thorough debridement, SUPRATHEL® forms a physical barrier against microorganisms. It also reduces the pH-value of the wound, thus inhibiting growth of bacteria and viruses.
Lavanid®Acetic acid 3%
Paraffinated gauzes such as
Bridal Veil or N-Terface® (in combination with Bacitracin®/Polysporin®)
Jelonet® (most commonly used)
Insufficient debridement: consider surgical (sharp) debridement in deeper wounds. SUPRATHEL® applied too early after trauma: wait for 24 hours after trauma in case of deeper wounds. Consider Lavasept® dressing after debridement.
Insufficient hemostasis: Use 1% adrenaline and warm towels. Consider light compression dressing during the first 1-3 days. Some users utilize stripes or staples around the edges to fixate SUPRATHEL®.
Smaller 3° areas heal under SUPRATHEL®. Healing may take longer than 2b°. Advantages: Reduction or avoidance of split skin graft. Time-saving, in case split skin grafting is not possible or temporarily not available. In general: If no healing or wound closure after 14 days, area must be transplanted with split thickness skin graft. Not indicated in the US
SUPRATHEL® should be stored in a refrigerator between 8°C (46°F) and 22°C (71°F)
SUPRATHEL® is delivered in a cooling box keeping the temperature within this range. When the membrane is white and non-transparent, it is in proper condition.
Baartmans et al. 2010: Baartmans MG, Dokter J, den Hollander JC, Kroon AA, Oranje AP. Use of Skin Substitute Dressings in the Treatment of Staphylococcal Scalded Skin Syndrome in Neonates and Young Infants. Neonatology. 2010 Dec 9;100(1):9-13.
Baartmans M.G.A., Dokter J., den Hollander J.C., Kroon A.A. & Oranje A.P. (2010). Use of Skin Substitute Dressings in the Treatment of Staphylococcal Scalded Skin Syndrome in Neonates and Young Infants. Neonatology. 100(1):9-13.
Behr et al. 2008: Behr B, Megerle KO, Germann G, Kloeters O. Neue Konzepte in der Oberflächentherapie bei Verbrennungswunden. -New concepts in local burn wound therapy. Handchir Mikrochir Plast Chir. 2008 Dec;40(6):361-6.
Gerlach JC, Johnen C, McCoy E, Bräutigam K, Plettig J, Corcos A. Autologous skin cell spray-transplantation for a deep dermal burn patient in an ambulant treatment room setting. Burns. 2011 Jun;37(4):e19-23. doi: 10.1016/j.burns.2011.01.022. Epub 2011 Feb 19. No abstract available. PMID: 21334816 [PubMed – indexed for MEDLINE] Related citations
Harenberg et al. 2010: Harenberg PS, Hrabowski M, Ryssel H, Gazyakan E, Germann G, Engel H, Reichenberger MA. Febrile Ulceronecrotic Mucha-Habermann Disease. Eplasty. 2010 Jul 16;10.
Herold et al. 2011: Herold C, Busche MN, Vogt PM, Rennekampff HO. Autologe nichtkultivierte Keratinozytensuspension in der Verbrennungschirurgie – Indikationen und Anwendungstechniken. GMS Verbrennungsmedizin 2011, Vol. 4, ISSN 1869-1412
Highton et al. 2013: Highton L, Wallace C, Shah M. Use of Suprathel® for partial thickness burns in children. Burns 2013 Feb;39(1):136-41.
Kaartinen et al. 2011: Kaartinen IS, Välisuo PO, Alander JT, Kuokkanen HO. Objective scar assessment- a new method using standardized digital imaging and spectral modelling. Burns. 2011 Feb;37(1):74-81.
Kaartinen and Kuokkanen 2011: Kaartinen IS, Kuokkanen HO. Suprathel(®) causes less bleeding and scarring than Mepilex(®) Transfer in the treatment of donor sites of splitthickness skin grafts. J Plast Surg Hand Surg. 2011 Sep;45(4-5):200-3
Keck et al. 2011: Keck M, Selig HF, Lumenta DB, Kamolz LP, Mittlböck M, Frey M. The use of SUPRATHEL(®) in deep dermal burns: First results of a prospective study. Burns. 2012 May;38(3):388-95. Epub 2011 Nov 10.
Kraemer et al. 2010: Kraemer B, Wallwiener M, Brochhausen C, Planck C, Hierlemann H, Isaacson KB, Rajab TK, Wallwiener C. A Pilot Study of Laparoscopic Adhesion Prophylaxis after Myomectomy with a Copolymer Designed for Endoscopic Application. J Minim Invasive Gynecol. 2010 Mar-Apr;17(2):222-7.
Lindford et al. 2011: Lindford AJ, Kaartinen IS, Virolainen S, Vuola J. Comparison of Suprathel® and allograft skin in the treatment of a severe case of toxic epidermal necrolysis. Burns. 2011 Nov;37(7):e67-72. Epub 2011 Aug 17.
Lindford et al. 2011 (2): Lindford AJ, Kaartinen IS, Virolainen S, Kuokkanen HO, Vuola J. The dermis graft: Another autologous option for acute burn wound coverage. Burns. 2012 Mar;38(2):274-82. Epub 2011 Sep 7
Lumenta et al. 2009: Lumenta DB, Kamolz LP, Frey M. Adult burn patients with more than 60% TBSA involved-Meek and other techniques to overcome restricted skin harvest availability– the Viennese Concept. J Burn Care Res. 2009 Mar-Apr;30(2):231-42.
Madry et al. 2011: Madry R, Struzyna J, Stachura-Kulach A, Drozdz L, Bugaj M. Effectiveness of Suprathel® application in partial thickness burns, frostbites and Lyell syndrome treatment. Pol Przegl Chir. 2011 Oct 1;83(10):541-8.
Markl et al. 2010: Markl P, Prantl L, Schreml S, Babilas P, Landthaler M, Schwarze H. Management of split-thickness donor sites with synthetic wound dressings: results of a comparative clinical study. Ann Plast Surg. 2010 Nov;65(5):490-6.
Merz et al. 2009: Merz KM, Wisser D, Sievers R, Reichert B. Erste Erfahrungen mit SUPRATHEL® bei zweitgradig oberflachlichen Verbrennungen im Gesicht. Plastische Chirugie 4/2009:213-18.
Merz et al. 2011: Merz KM, Sievers R, Reichert B. Suprathel®bei zweitgradig oberflächlichen Verbrennungen im Gesicht. -Suprathel® for coverage of superficial dermal burns of the face. GMS Verbrennungsmedizin 2011, Vol 4, ISSN 1869-1412
Mueller et al. 2010: Mueller E, Haim M, Petnehazy T, Acham-Roschitz B, Trop M. An innovative local treatment for staphylococcal scalded skin syndrome. Eur J Clin Microbiol Infect Dis. 2010 Jul;29(7):893-7.
Nolte et al. 2007: Nolte SV, Xu W, Rodemann H-P, Rennekampff H-O. Suitability of Biomaterials for Cell Delivery in Vitro. Osteo trauma care 2007; 15: 42-47.
Pfurtscheller et al. 2008: Pfurtscheller K, Zobel G, Roedl S, Trop M. Use of Suprathel dressing in a young infant with TEN. Pediatr Dermatol. 2008 Sep-Oct;25(5):541-3.
Rahmanian-Schwarz et al. 2011: Rahmanian-Schwarz A, Beiderwieden A, Willkomm LM, Amr A, Schaller HE, Lotter O. A clinical evaluation of Biobrane(®) and Suprathel(®) in acute burns and reconstructive surgery. Burns. 2011 Dec;37(8):1343-8. Epub 2011 Aug 17
Rajab et al. 2009: Rajab TK, Wallwiener CW, Brochhausen C, Hierlemann H, Kraemer B, Wallwiener M. Adhesion prophylaxis using a copolymer with rationally designed material properties. Surgery. 2009 Feb;145(2):196-201.
Rapp et al. 2007 : Rapp, M, Uhlig C, Dittel K-K. The Treatment of Mass Burn Casualties Resulting from Mass Disaster. Osteo trauma care 2007; 15: 8-16.
Ring et al. 2011: Ring A, Tilkorn D, Ottomann C, Geomelas M, Steinstraesser L, Langer S, Goertz O. Intravital monitoring of microcirculatory and angiogenic response to lactocapromer terpolymer matrix in a wound model. Int Wound J. 2011 Apr;8(2):112-7.
Ryssel et al 2010: Ryssel H, Gazyakan E, Germann G, Hellmich S, Riedel K, Reichenberger MA, Radu CA. Antiseptic therapy with a polylacticacid-acetic acid matrix in burns. Wound Repair Regen. 2010 Sep-Oct;18(5):439-44.
Ryssel et al. 2010: Ryssel H, Germann G, Riedel K, Reichenberger M, Hellmich S, Kloeters O. Suprathel-acetic acid matrix versus acticoat and aquacel as an antiseptic dressing: an in vitro study. Ann Plast Surg. 2010 Oct;65(4):391-5.
Ryssel et al. 2011: Ryssel H, Andreas Radu C, Germann G, Kloeters O, Riedel K, Otte M, Kremer T. Suprathel-antiseptic matrix: in vitro model for local antiseptic treatment? Adv Skin Wound Care. 2011 Feb;24(2):64-7.
Schwarze et al. 2007: Schwarze H, Küntscher M, Uhlig C, Hierlemann H, Prantl L, Noack N, Hartmann B. Suprathel, a new skin substitute, in the management of donor sites of splitthickness skin grafts: results of a clinical study. Burns. 2007 Nov;33(7):850-4.
Schwarze et al. 2008: Schwarze H, Küntscher M, Uhlig C, Hierlemann H, Prantl L, Ottomann C, Hartmann B. Suprathel, a new skin substitute, in the management of partial-thickness burn wounds: results of a clinical study. AdhesionAnn Plast Surg. 2008 Feb;60(2):181-5.
Schwarze et al., Burns Nov. 33/2007; Everett at al., J. Wound Care 24/2015
Uhlig et al. 2007: Uhlig C, Rapp M, Dittel KK. Neue Strategien zur Behandlung thermisch geschädigter Hände unter Berücksichtigung des Epithelersatzes Suprathel. -New strategies for the treatment of thermally injured hands with regard to the epithelial substitute Suprathel. Handchir Mikrochir Plast Chir. 2007 Oct;39(5):314-9.
Uhlig et al. 2007: Uhlig C, Rapp M, Hartmann B, Hierlemann H, Planck H, Dittel KK. Suprathel-an innovative, resorbable skin substitute for the treatment of burn victims. Burns. 2007 Mar;33(2):221-9.
Uhlig et al. 2007: Uhlig C, Hierlemann H, Dittel K-K. Actual Strategies in the Treatment of Severe Burns – Considering Modern Skin Substitutes. Osteo trauma care 2007; 15: 2-7.
Uhlig et al., Burns 33/2007; Schwarze at al., Am. Plast. Surgey 60/2009; Markl et al., Am Plast. Surg. 65/2010; Highton et al., Burns 39/2013
Uhlig et al., Burns Nov. 33/2007; Schwarze at al., Burns Nov. 33/2007; Keck et al., Burns 2012; Uhlig et al., Burns Nov. 33/2007; Highton et al., Burns 39/2013
Wallwiener et al. 2006: Wallwiener M, Brucker S, Hierlemann H, Brochhausen C, Solomayer E, Wallwiener C. Innovative barriers for peritoneal adhesion prevention: liquid or solid? A rat uterine horn model. Fertil Steril. 2006 Oct; 86 (4 Suppl): 1266-76