Annals of the MBC - vol. 3 - n' 1 - March 1990 CRYOPRESERVED ALLOGRAFT SKIN TO COVER 50% DEEP BURNSPousa Real F. Serv. de Cirurgia Plastica, Hospital Juan Canalejo, La Coruna, Espaha SUMMARY. Cryopreserved allograft skin from cadaveric sources has proved to be an excellent material for burn wound covering, allowing temporary closure of the wound 10 days post-bum. Its use has many advantages in the case of second- or third-degree burns. The methods of obtaining, preserving and applying the skin are described. Two case histories are also given. Concept Viable human allograft skin from cadaveric sources has proved to be a very effective material to cover ' tangentially excised deep second- or third-degree bum wounds when insufficient amounts of autografts have been present. Allograft cryopreserved skin has performed as both a mechanical and a physiological barrier, and its use has decreased the loss of water, protein and heat through the burn wound, as well as preventing contamination of the wound by enviromental micro-organisms. History From the pioneer works of Baronio etc. up to the latest works of Randolf May more than 300 works have been published on this subject. Patients and methods
Transport and use of frozen skin: Case 1 A 50-year-old male with 2nd-3rd degree burns which affected 85% BSA, 60% of which could be established as being deep: tangential excision was used and the wounds were covered with a cryopreserved allograft after the eighth, fifteenth and twenty-first days until a total covering of the wound bum was achieved. This was substituted by meshed autografts 1:3 over well-vascularized allogenic dermis. The patient was able to leave hospital after 65 days. Case 2 An 18-month-old male child presenting 2nd-3rd degree burns in 40% BSA: our aim was to cover tangentially excised deep second- or third-degree burn wounds with only one surgical operation ten days after being taken into hospital, with grafted allotype skin. It showed signs of rejection in the contact areas after 18 days, being replaced by meshed autograft 1:3, with the result that the burn wound closed. He could leave hospital after 40 days.
Conclusion Cryopreserved allograft is the best material for wound covering. It allows temporary closure of the wound 10 days post-burn. This reduces pain, the number of dressings, and contamination of the bums by germs.
The patient's comfort is increased as also recovery of the
haematological factor, platelets, clotting factors, the increase in red blood cells,
nitrogen balance, etc. RÉSUMÉ. L'allogreffe de peau cryoconservée d'origine cadavérique s'est montrée un matériau excellent pour la couverture des brûlures parce qu'elle permet la fermeture temporaire de la plaie 10 jours après la brûlure. Elle offre beaucoup d'avantages dans le cas de brûlures de 2éme et de 3ème degré. L'Auteur explique les méthodes pour obtenir, conserver at appliquer la peau, et il décrit deux cas. |
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