• R Horch, G B Stark, J Kopp, and G Spilker.
• Department of Plastic and Reconstructive Surgery, Cologne Medical Centre Merheim, Germany.
• Burns. 1994 Jan 1;20 Suppl 1:S23-6.

AbstractIn an effort to improve the take of finely meshed autografts a modification of the sandwich technique, as first published by Alexander et al. (1981), was developed. In contrast to the techniques described by other authors, the wound bed is sealed with fibrin glue spray after excision of the burns. Widely meshed autografts are then covered with non-meshed (only scarcely sliced) glycerolized allograft sheets, being fixed with staples. Patients are placed on fluidized beds and are exposed without dressings from the fifth day onwards. Histologically and clinically, it can be assumed that part of the glycerolized allodermis is incorporated. During the weeks after transplantation, a creeping substitution of the allodermis by autologous tissue takes place. This would suggest a co-existence between glycerol-preserved hypo-allergenic allografts and auto-epidermis. Research on the definitive fate of allodermis in cases of sandwich grafting is continuing.

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