Treating Burns with Autograft and Artificial Skin
treatment of burns
Treating Burns with Antimicrobial dressings
can adversely affect wound healing, and require daily maintenance
whereas Biological dressings
no direct toxins or antimicrobial
properties. However, they do reduce loss of heat, water, protein and
red blood cells, and promote more rapid wound healing.
Biological dressings also reduce burn wound pain.
These materials may be organic or synthetic in origin, but good wound
adherence especially in 3rd degree burns
is the key function.
Organic materials include, skin allograft
from donors, autograft
patient, pigskin (xenograft)
from cadavers, human amnion
and artificial skin
Biobrane© Op-site© and Omiderm©.
- Autograft is usually only
possible if the patient's burns are less than 70%, then the other
alternatives for treating burns would be checked Autografts are taken
from the thighs or buttocks where the resulting scars would be hidden.
The thickness of the skin takes in the Epidermis and part of the Dermis,
about the equivalent of 2nd Degree Burns, it is then put through a
meshing machine which allows the skin to be expanded from 2 to 4 times
it's original area. Healing of subsequent skin autograft can be
expected in areas of good allograft 'take', thereby eliminating hypertrophic
- Fresh skin allograft has
become the standard for temporary coverage of the clean open burn
wound, it achieves an environmental 'seal' of the burn wound at the
graft-wound interface and improves host immune defenses.
- Homograft human skin graft
can be obtained from fresh cadavers within 18 hours of death .
The graft can re-vascularize once adhered to the wound., but rejection
will occur within 14 days.
- Allograft and Homograft
provide the best temporary closure of the excised burn wound.and will
undergo rejection in 7 to 14 days in normal patients.When peeled off,
the underlying surface is granulated and heals up with minimal scarring.
- Xenograft (pigskin)
degenerates before it is rejected but provides the same level of
protection from infection as allograft, so pigskin is often embedded
with salts of antimicrobial agents to increase its bacteriostatic
potential.Pigskin is cheaper and more available than allograft. Its
recommended uses include protective coverage of partial-thickness
wounds and should be changed every 3-4 days to prevent infection.
- Artificial Skin dressings
provide wound protection, increase the rate of wound healing, and
reduce patient discomfort. Very careful application is essential. When
used to cover clean partial-thickness wounds, the dressing detaches as
healing occurs underneath.
Biobrane© is a synthetic, membrane with an outer silicone layer bonded
to an inner collagen nylon matrix. Its elasticity and transparency
allows easy drape ability, fuller range of movement and easy wound
The major problems with Biobrane© in treating burns are its expense and
its lack of inherent antimicrobial properties. Wound infections are not
In my particular case
both Autograft and Homograft were used in treating burns. Autograft for
my left hand, arm from wrist to shoulder, rib cage and neck, while
Homograft was applied across the top of my chest.
The hand and arm were the first areas to be grafted with split skin Autografts
taken from my thighs and were completely successful. The next stage was
my upper arm and ribcage, but the site became infected with MRSA
and the grafts didn't 'take' and just dropped off, making healing a
much longer process, and leaving extensive hypertrophic
across the chest
very well, but after a while became very smelly, unbearably so, and
right under my nose, so I told the Doctor that I'd take them off myself
and hide them in the dashboard of his car. He took them off right away,
and the healing that had taken place under them was incredible, and has
left very little scarring.
Other Methods for Treating Burns can be found in Sunburn
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