title: Short- and long-term outcomes of small auto- and cryopreserved allograft skin grafting in those with >60%TBSA deep burn wounds.
abstract: BACKGROUND
  The shortage of autologous skin sources not only adds difficulty to the repair of extremely large-area deep burn wounds but affects the healing quality. The aim of the present study is to explore an ideal method for repairing large-areas burn wounds with low scar formation.
  
  
  METHODS
  Between 2002 and 2014, we used grafting of small auto- and cryopreserved allo-skin to repair large-area residual burn wounds in wounds after 21 days 21 patients, and after early excision in 17 patients. The wound healing rate and quality were observed.
  
  
  RESULTS
  The skin expansion rate was 1:9-1:16, and the mean area of wounds repaired after three weeks was 64.8±7.3%TBSA, the wound healing rate was 91.8±3.7%. The mean area of the early excision group was 65.9±9.8 TBSA, where the healing rate was 94.5±5.6%. After small auto- and cryopreserved allograft skin grafting, the epidermis of the auto-skin gradually replaced the allo-epidermis, and the allo-dermis persisted for a prolonged period. The dermal collagen fibers at the allo-skin grafting sites were well arranged. At 1-2-year follow-up, observation showed that the Vancouver Scar Scale total score was 4·304±2·363, and we did not discern significant contracture and dysfunction in the large joints of the four extremities.
  
  
  CONCLUSIONS
  Small auto- and cryopreserved allograft skin grafting of small auto- and allo-skin not only raised the graft expansion rate but offers a stable wound healing rate. This new technique may provide an option for repair of large-area deep burn wounds.
authors.affiliation: Burns Center of Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Shizhao
authors.affiliation: Burns Center of Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Yongjun
authors.affiliation: Burns Center of Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Zhang
authors.initials: Z
authors.lastname: Lisen
authors.affiliation: Burns Center of Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Luo
authors.initials: L
authors.lastname: Pengfei
authors.affiliation: Burns Center of Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Xiaopeng
authors.affiliation: Burns Center of Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Guangyi
authors.affiliation: Burns Center of Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Zhu
authors.initials: Z
authors.lastname: Shihui
authors.affiliation: Burns Center of Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Hu
authors.initials: H
authors.lastname: Xiaoyan
authors.affiliation: Burns Center of Changhai Hospital, The Second Military Medical University, Shanghai, China. Electronic address: huangzhuoxiao@sohu.com.
authors.forename: Xiao
authors.initials: X
authors.lastname: Shichu
authors.affiliation: Burns Center of Changhai Hospital, The Second Military Medical University, Shanghai, China. Electronic address: xiazhaofan_smmu@163.com.
authors.forename: Xia
authors.initials: X
authors.lastname: Zhaofan
mesh_terms: D000328:Adult; D001830:Body Surface Area; D002056:Burns / Q000150:complications / Q000601:surgery*; D002921:Cicatrix / Q000209:etiology; D003286:Contracture / Q000209:etiology; D015925:Cryopreservation; D020405:Dermis / Q000637:transplantation; D004817:Epidermis / Q000637:transplantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D060053:Transplant Donor Site; D014182:Transplantation, Autologous / Q000379:methods*; D014184:Transplantation, Homologous / Q000379:methods*; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014945:Wound Healing
keywords: Mixed grafting; Residual wound; Scar formation; Severe burns; Wound healing