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Live Skin Allograft in the Management of Severe Burns

Shaban Saidi

Nyeri Provincial General Hospital

Correspondence to: Dr. Shaban Saidi, P.O Box 27 Nyeri.

Email: sogshaban@yahoo.com

Abstract

Introduction: Deep burn injuries lead to dermal damage that impairs the ability of the skin to heal and regenerate on its own. Skin autografting is considered the current gold standard of care, but lack of patient’s own donor skin may require the temporary use of skin substitutes to promote wound healing, reduce pain, and prevent infection and abnormal scarring. These alternatives include donor skin allograft, xenograft, cultured epithelial cells and biosynthetic skin substitutes. Skin allograft is the use of skin from a genetically non-identical member of the same species as the recipient. Human deceased or live donor skin allografts represent a suitable and much used temporizing option for skin cover following severe burn injury until autografting is possible or re-harvesting of donor sites becomes available. Disadvantages of its use include the limited abundance and availability of donors, possible transmission of disease, the eventual rejection by the host and its handling, storing, transporting and associated costs of provision. Methods: Between August 2010 and August 2014, five patients underwent live skin allografting without medical immunosuppresion. All patients had deep severe burns of more than 40% burn surface area. 3 skin donors were patients’ mothers while 2 were brothers. Results: Three patients had complete healing not requiring skin autografting. One patient had hyper acute rejection and another had normal rejection and underwent secondary auto grafting. Conclusion: Live skin allografting is a useful skin substitute for severely burnt patients in resource limited areas

 

Keywords: Burns, Allograft, Immunosuppresion, Family Donor

Ann Afr Surg. 2016;13(2): 77-80.

DOI: http://dx.doi.org/10.4314/aas.v13i2.10

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Introduction

The gold standard for burn wound coverage remains the autologous split-thickness skin graft. However, severe burn patients lack adequate skin donor sites to resurface their burn woundscalling for the use of skin substitutes to meet the shortfall. Skin substitutes are also referred to as artificial skin. In the broadest sense, a skin substitute is anything that substitutes for any of the skin functions. It may be synthetic or biological (1). However, to be more than just a dressing, a biologic skin substitute should in some way be incorporated into the healing wound as happens with allografts and xenografts (2). Cadaveric grafts and porcine grafts are skin substitutes that have been used clinically