• Ji Shizhao, Zheng Yongjun, Zhang Lisen, Luo Pengfei, Zheng Xiaopeng, Wang Guangyi, Zhu Shihui, Hu Xiaoyan, Xiao Shichu, and Xia Zhaofan.
• Burns Center of Changhai Hospital, The Second Military Medical University, Shanghai, China.
• Burns. 2017 Feb 1; 43 (1): 206-214.

BackgroundThe 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.MethodsBetween 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.ResultsThe 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.ConclusionsSmall 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.Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

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