The use of intermingled autograft and parental allograft skin in the treatment of major burns in children.
Large burns continue to pose the problem of providing sufficient autologous skin cover. The experience of this unit using cultured keratinocytes as a substitute for split-skin grafts has been disappointing; at the same time, we have been obliged to abandon human allograft skin from cadavers and other patients because of the possibility of infection with HIV. Our favoured method for resurfacing large-area burns in children is to use widely meshed autologous skin overlaid with meshed allograft from a parent (to minimise the risk of HIV transmission). We report our experience using this technique in 10 children. The fate of the intermingled grafts has been followed clinically, and in some cases histologically and by Y-chromosome identification. There has generally been long-term persistence of the parental skin without rejection, and allograft dermis appears to contribute to the final cover. Evidence suggests, however, that cellular elements of the parental skin do not survive.
Phipps
A R
AR
South West Thames Regional Burns Unit, Queen Mary's University Hospital, London.
Clarke
J A
JA
D002056:Burns / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D016038:Skin Transplantation; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous