MIDTERM RESULTS WITH CULTURED EPIDERMAL AUTOGRAFTS, ALLOGENIC SKIN TRANSPLANTS AND CYCLOSPORINE-A MEDICATION

Transplantation of allogenic split thickness skin grafts (STSG) and im munosuppression with cyclosporin A enable early and definitive skin re placement of extensive, deep partial and full thickness burns. Coverin g burn defects with definitely engrafted, allogenic dermis and cultiva ted epithelial autografts (CEA) permits the subsequent withdrawal of c yclosporin A medication. Light-microscopy examination of biopsies, tak en 12 and 24 months postgrafting, and electron microscopy of biopsies taken 12 months postgrafting, demonstrates a re-established, but somew hat reduced anchoring of the CEA as compared with a normal epidermal-d ermal junction. Clinical inspection, 20 months postgrafting, confirms the histological observations that epifascial transplantation is quali tatively inferior to placing the allogenic STSG on the subcutaneous ti ssue. In the first situation, the dermis is inelastic and collagen dep osition is excessive, whereas in the second case collagen deposition i s comparatively reduced and the dermis shows clinically some elasticit y.