COMBINED USE OF ALLOGRAFT AND AUTOGRAFT EPIDERMAL CULTURES IN THERAPYOF BURNS

Cultivation of human epidermal keratinocytes made possible the use of cultured autografts as part of the therapy of extensively burned patie nts. On the basis of our early results using banked cultured allograft s and autografts, we developed an integral and combined burn therapy c omprising banked cultured allografts for rapid healing of skin donor s ites and deep partial-thickness burns, conventional split-thickness sk in autografting, and when needed, cultured autografts for full-thickne ss burns. We compared hospital stay in 32 burn patients treated with t he combined therapy and in 39 who were not treated with cultured epide rmis. Three groups of patients were defined: 15 to 29 percent (n = 12) , 30 to 49 percent (n = 10), and more than 49 percent (n = 10) burned body surface area. We found a 20 to 29 percent decrease in hospital st ay in patients with up to 49 percent burned body surface area and a 46 percent reduction in patients suffering more extensive burns. Surviva l rate of extensively burned patients also was increased. We took adva ntage of the availability of banked cultured allografts for ambulatory treatment, without hospitalization, of pediatric patients with 5 to 2 0 percent burned body surface area. We show for the first time the use and benefits of this combined therapy.