USE OF CULTURED EPIDERMAL AUTOGRAFTS IN THE TREATMENT OF LARGE BURNS

Mortality in patients with large areas of full skin thickness burns is , in part, due to complications developing during the period of prolon ged delay required to obtain enough wound healing to permit skin graft ing from limited donor sites. Cultured epithelial autograft (CEA) has become limited donor sites. Cultured epithelial autograft (CEA) has be come available as an alternative measure to the use of expanded skin a utografts and regrafting. Small biopsies are taken and transported to the laboratories of BioSurface Technology where keratinocytes are grow n to cover large areas during a 3-week period. The cultured keratinocy tes are then available on petroleum jelly gauze which is applied to th e patient. The gauze is used as a temporary dressing. To date; 37 pati ents have been biopsied. Grafts have been applied in 15. Graft 'take' averaged 71.5 per cent at our institution. Two of the patients grafted with CEA died of sepsis. One patient had a 100 per cent loss of the C EA grafts. In 12 patients, the use of CEA probably contributed signifi cantly to wound coverage and survival. Such grafts are more susceptibl e to mechanical loss than routine autograft, although long-term covera ge after several years is considered to be satisfactory. The cost of t he process is high.