The use of glycerol-preserved allografts in the Beverwijk Burn Centre: a retrospective study.
This report describes 156 consecutive patients treated with glycerol-preserved allograft skin (GPA) in the Beverwijk Burn Centre between January 1996 and July 2001. Patients with burn and non-burn lesions are included. Age varied from 7 months to 90.7 years. Four different procedures have been identified: (1) sandwich grafting technique; (2) treatment of partial-thickness burns with GPA as a membranous dressing; (3) improvement of wound condition; (4) scar release: a temporary coverage of release incisions with allograft skin to improve the wound bed and to benefit further relaxation of the wound primary to autografting. The main points of interest in this inventory are the results of treatment, the aetiology and the extent of the wounds treated with GPA, the day post injury the GPA treatment was started, the duration of the treatment, the number of allograft applications, the occurrence of wound infection and wound treatment before GPA application. Concerning the scar release an inventory was made of the anatomic sites that were involved. Sandwich grafting, which is the treatment of choice at this centre for extensive, full-thickness injuries, was performed on 129 wounds. The average burn size in all 70 patients treated was 35.6% TBSA with 26.9% full thickness. In all cases meshed GPA was used. Partial or complete healing was achieved in 57.6% of wounds. In the treatment of partial-thickness burns, non-meshed GPA was used in all 57 cases. Complete healing without further treatment was achieved in 45.6% of the cases. Excision and autologous skin grafting was needed in 26.3% of the cases. Meshed GPA was used to improve the condition of 88 non-healing wounds. Spontaneous healing was promoted in 13.6% of the wounds, and the wound bed was successfully prepared for autografting in 39.8% of the cases. In all 52 scar releases a viable wound bed was obtained prior to autografting. Autologous graft take was 100% and no autologous re-grafting was necessary. Allografts in the popliteal space were changed most frequently.
Vloemans
A F P M
AF
Burn Centre, Rode Kruis Ziekenhuis, Vondellaan 13, 1942 LE Beverwijk, The Netherlands. bwcavm@rkz.nl
Schreinemachers
M C J M
MC
Middelkoop
E
E
Kreis
R W
RW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003286:Contracture / Q000601:surgery; D005990:Glycerol; D006084:Graft Rejection; D006801:Humans; D007223:Infant; D008875:Middle Aged; D019188:Organ Preservation Solutions; D012189:Retrospective Studies; D012867:Skin; D016038:Skin Transplantation / Q000379:methods*; D013526:Surgical Mesh; D014021:Tissue Preservation / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing
D019188:Organ Preservation Solutions; D005990:Glycerol