The Use of Close Relative Allo-Graft Intermingled with Auto-Graft for the Management of Extensive Burn Injury

Document Type : Research article

Authors

1 The Burn Center, Ahmed Maher Teaching Hospital

2 Faculty of Medicine, Mansoura University

Abstract

Major burn injury management represents a difficult issue
especially in developing countries. Skin auto-grafts is the best
natural skin substitute for replacing burned skin but its rarity
in major burns patients stand as an obstacle to be used. Early
deep burn wounds excision and coverage of wounds more
than 30% of body surface area is the main strategy for wound
management in massive burns yet with the absence of skin
banks (skin allo-grafts) and expensive artificial skin substitute's
coverage of raw wounds by these methods is not applicable
in Egypt. In this study, we try to evaluate the benefits to use
both minimal sheets of auto-grafts covered by enough sheets
of allo-grafts to cover all raw area after excision. Using fresh
skin allo-grafts obtained from 1st degree relative of patients
as natural skin substitute. The auto-grafts are meshed 1 to 6
and fixed directly on raw areas while allo-grafts are meshed
1 to 2 and cover both auto-grafts and raw areas, noting that
allo-grafts considered as temporary skin. Follow-up the clinical
changing of these grafts and histopathologically analysis. Out
of the 30 patients 8 had died, 10 patients needed other operations
while 12 had healed with no more procedures.

Keywords

Main Subjects

References

1- Tompkins R.G.: Survival from burns in the new millennium:
70 years experience from a single institution. Ann.
Surg., 261 (2): 263-8: 2015.
2- Chu D.H.: Overview of biology, development, and structure
of skin. In K. Wolff, L.A. Goldsmith, S.I. Katz, B.A.
Gilchrest, A.S., 241-242, 2008.
3- Daugherty M.D., Timothy H.F. M.D., Amanda Ross M.D.
and Michael Neumeister M.D.: Surgical Excision of Burn
Wounds Best Practices Using Evidence-Based Medicine.
Clin. Plastic Surg., 33-38, 2017.
4- Saidi S.: Live Skin Allograft in The Treatment of Severe
Burn. Annals of African Surgery, 13 (2): 77-80, 2016.
5- Sutithanthiran N.: Acute rejection of renal allografts:
Mechanistic insights and therapeutic options Kidney
International, 51: 1289-1304, 1997.
6- Converse J.M. and Duchet G.: Successful homologous
skin grafting in a war burn using an identical twin as a
donor. Plastic and Reconstructive Surgery, 3: 342, 1947.
7- Coenen J.M.H., Klasen H.J. and Sauer F.W.: Successful
homografting in an elderly patient with extensive burns
using his identical twin brother as skin donor. Burns, 16
(3): 225-226, 1990.
Egypt, J. Plast. Reconstr. Surg., July 2020 429
8- Leodoro B., Chang A. and Cama J.K.: Live sibling skin
allo-grafts for severe burns in a pediatric patient. Journal
of Pediatric Surgery Case Reports, 2 (11): 498-500, 2014.
9- Alexander J.W., MacMiian B.W., Law E. and Kittur D.S.:
Treatment of severe bums with widely meshed skin
autograft and meshed skin allograft overlay. Journal of
Trauma, 21: 433, 1981.
10- Calota D.R., Nitescu C., Florescu I.P., et al.: Surgical
management of extensive burns treatment using allografts.
J. Med. Life, 5 (4): 486-490, 2012.
11- Phipps and Clarke J.A.: The use of intermingled autograft
and allograft skin in the treatment of major burns in
children. Br. J. Plastic Surgery, 44 (8): 608-611, 1991.
12- El-Meanawy Amr Mahmoud, Tarek Fouad Keshk, Magdy
Ahmed Lolouah and Medhat Samy Hassan: The reliability
of use of combined homograft and autograft in management
of major burns, 6 (5): 1446-1452, 2019.
13- Qaryoute S., Mirdad I. and Hamail A.A.: Usage of autograft
and allograft skin in treatment of burns in children. Burns,
27: 599-602, 2001.
14- Chua A.W.C., Khoo Y.C., Truong T.T.H., Woo E., Tan B.K.
and Chong S.J.: From skin allograft coverage to allograftmicrograft
sandwich method, 44 (5): 1302-1307, 2018.
15- Ninnemann J.L., Fisher J.C. and Frank H.A.: Prolonged
Survival of Human Skin Allografts Following Thermal
Injury Transplantation, 25 (2): 69-72, 1979.
16- Coruh Atilla M.D., Zeynep Tosun M.D. and Umut Ozbebit
M.D.: Close Relative Intermingled Skin Allograft and
Autograft Use in the Treatment of Major Burns in Adults
and Children Journal of Burn Care & Research, 26 (6):
471-477, 2005.

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