title: Utility of acellular allograft dermis in the care of elderly burn patients.
abstract: BACKGROUND
  Because skin thins with advancing age, traditional thickness skin grafts cannot always be obtained in very elderly burn patients without creating a new full-thickness wound at the skin graft donor site.
  
  
  METHODS
  In an attempt to circumvent this problem, acellular allograft dermis (Alloderm, Life Cell Corp., The Woodlands, TX) and thin autograft (depth 0.005 inches) was used in skin grafting 10 elderly burn patients (age 78 year +/- 2, TBSA burn 17% +/- 2; mean +/- SEM) over a 1-year period. The outcome of patients receiving Alloderm was compared retrospectively to a similar group of 18 elderly patients admitted over the prior year, eight of whom underwent operative wound excision and autografting (depth 0.014 inches) without Alloderm.
  
  
  RESULTS
  Length of hospital stay was significantly reduced in patients treated with Alloderm compared to the total group of elderly in whom selective use of operative debridement and skin grafting was used. Functional outcome was improved in those patients who underwent skin grafting regardless of operative technique. Donor site healing time was significantly reduced with Alloderm (12 days +/- 1 versus 18 days +/- 2), while graft take was similar to conventional autografting. Unfortunately, 3-month mortality remained poor regardless of operative skin grafting or technique used.
  
  
  CONCLUSIONS
  This initial experience suggests that use of Alloderm may allow more elderly burn patients to undergo operative wound closure, thus improving functional outcome and reducing hospitalization. Unfortunately, long-term survival for very elderly burn patients remains poor.
authors.affiliation: Department of Surgery, The University of Texas Medical Branch, Galveston, Texas 77555, USA. dcgore@utmb.edu
authors.forename: Dennis C
authors.initials: DC
authors.lastname: Gore
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D016038:Skin Transplantation; D014184:Transplantation, Homologous; D014945:Wound Healing