Clinical Practice Using Allograft Skin in the Treatment of Massive Burns

J Korean Wound Management Soc > Volume 2(1); 2006 > Article

Original

Journal of the Korean Wound Management Society 2006;2(1): 8-13.

동종피부를 이용한 광범위 화상의 치료

전욱

한림대학교 의과대학 한강성심병원 외과학교실

Clinical Practice Using Allograft Skin in the Treatment of Massive Burns

Wook Chun

Department of Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea

Published online: 31 May 2005.

ABSTRACT

The most common cause of death in massive burn patients is burn wound sepsis. Therefore we have been using allograft skin for preventing burn wound sepsis. Included in this study were 71 subjects who had sustained extensive burns from December 2003 through February 2006. 1. Early selective Escharectomy was performed for full thickness burn areas. 2. Allograft skins were grafted on excision area. 3. An autograft was performed for areas with a formation of granulation after the allograft skin had come away. 4. A modified sandwich grafting technique (1：4∼6 meshed autograft with Cultured Epithelial Autografts) was performed in large sized burns. 5. Acellular dermal substitute was concurrently used to prevent burn scar contraction on joint areas. Seventy one subjects were included (Fresh allograft: 9 cases, CPA: 42 cases, GPA: 20 cases). The average burn area was 41.8 (20∼92)% TBSA. The mean area of the allograft skin used was 26.9 (8∼70)% TBSA. The grafted allograft skins usually came away 3 weeks later. Four cases of initial take failure were occurred. All of these cases were pediatric patients using cadaver skin. Nine patients were dead from heart failure, severe inhalation, respiratory failure, pneumonia in old age, renal failure etc. There was no definite wound sepsis. Cultured Epithelial Autografts were used in fourteen cases. In twenty-five cases, acellular dermal substitute was simultaneously used. Early selective escharectomy, allograft skin coverage, acellular dermal substitutes and wide meshed autograft with CEA application would be immensely helpful techniques in patients with extensive burns. (J Korean Wound Care Soc 2006;2:8-13)

Key Words: Burns, Allograft skin