title: Auto-/homografting can work well even if both autograft and allograft are meshed in 4:1 ratio.
abstract: BACKGROUND
  Patients suffering major burns of more than 50% total burn surface area lack an adequate skin graft donor site to resurface extensive burn wounds and usually need widely meshed autografting and allografting. Anything over the 3:1 expansion ratio is strongly associated with low graft take, poor or delayed epithelialization, and hypertrophic scarring.
  
  
  METHODS
  In this study, both autografts and allografts were expanded at a 4:1 ratio. We aimed to use skin grafts effectively and to decrease the morbidity due to graft harvesting. Nine patients with major burns were treated with this method. Graft gain ratio and percentage of actual expansion to predicted expansion were calculated.
  
  
  RESULTS
  Ten auto-allografting procedures were performed on a mean of day 16. Graft take was over 95% successful. Five patients survived, and four patients died. The mean total burn surface area was 58.8% in patients who recovered, and 77.5% in the patients who died. The graft gain ratio was 74.8%. The actual expansion rate was 43.7% of the predicted expansion rate.
  
  
  CONCLUSIONS
  In this study, we demonstrated that the donor site morbidities were reduced and successful epithelialization was completed on the eighth day after using both autograft and allograft meshed with a 4:1 ratio.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Gülhane Military Medical Academy, Ankara, Turkey. drismailsahin@yahoo.com.
authors.forename: Ismail
authors.initials: I
authors.lastname: Sahin
authors.affiliation: Department of Plastic and Reconstructive Surgery, Gülhane Military Medical Academy, Ankara, Turkey.
authors.forename: Doğan
authors.initials: D
authors.lastname: Alhan
authors.affiliation: Department of Plastic and Reconstructive Surgery, Gülhane Military Medical Academy, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Nışancı
authors.affiliation: Department of Plastic and Reconstructive Surgery, Gülhane Military Medical Academy, Ankara, Turkey.
authors.forename: Fırat
authors.initials: F
authors.lastname: Ozer
authors.affiliation: Department of Plastic and Reconstructive Surgery, Gülhane Military Medical Academy, Ankara, Turkey.
authors.forename: Muhitdin
authors.initials: M
authors.lastname: Eski
authors.affiliation: Department of Plastic and Reconstructive Surgery, Gülhane Military Medical Academy, Ankara, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Işık
mesh_terms: D000328:Adult; D064591:Allografts; D064592:Autografts; D002056:Burns / Q000473:pathology / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016038:Skin Transplantation / Q000379:methods*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D055815:Young Adult