CULTURED AUTOLOGOUS KERATINOCYTES SUSPENDED IN FIBRIN GLUE (KFGS) WITH ALLOGENIC OVERGRAFT FOR DEFINITIVE BURN WOUND COVERAGE

In a patient with burns of 88% TBSA autologous cultured keratinocyte f ibrin glue suspension (KFGS) overgrafted with fresh split thickness al logenic skin was used as definitive wound coverage after epifascial de bridement and temporary allogenic closure. A total of 22% TBSA were cl osed in this way including a complete leg except the foot. For compari son, the contralateral leg was covered with conventional autologous sh eet grafts (CEA). Histology revealed a layered squamous epithelium, an d evidence of at least partial integration of allogenic dermis includi ng the formation of a well-organized rete structure even after deep ne cretomy. Besides the rapid stable closure and good skin quality, the n ew technique has the advantages of early availability, simple handling , easy repetition, and the transfer of actively proliferating epiderma l cells. This is the first case proving that KFGS with allogenic overg rafts leads to permanent epithelialization of large epifascial wounds. The technique compared favorably with CEA with regard to availability , handling, and stability.