COMPOSITE GRAFTS OF AUTOGENIC CULTURED EPIDERMIS AND GLYCEROL-PRESERVED ALLOGENEIC DERMIS FOR DEFINITIVE COVERAGE OF FULL-THICKNESS BURN WOUNDS - CASE-REPORTS

In patients with extensive deep burns and scare donor sites autogenic cultured epithelial grafts (auto-CEG) have become a real alternative. In deep burns the 'take' rate of auto-CEG applied directly on subcutan eous fat, fascia or muscle is unreliable and frequently disappointing. The auto-CEG seems to need a dermal base. Improved results have been reported when auto-CEG were applied to the dermal base of a viable cry opreserved donor skin. We extended this principle by using the dermal layer of non-viable glycerol-perserved donor skin (GPDS). We report on two patients with deep burns of 55 and 80 per cent TBSA in whom we us ed the composite grafting of auto-CEG on non-viable allogeneic dermis from GPDS. The estimated 'take' rates were 70 and 77 per cent. The gra fted areas remained stable for 4 and 8 months respectively. The two-la yer skin substitute gave a permanent cover for full thickness burn wou nds of higher quality and better 'take' rate than previous results, wh ere the auto-CEG had been grafted directly onto the debrided wounds.