Mini-autogenous skin grafts with skin homografts versus autogenous skin graft for covering post burn wounds in children

Abstract

Introduction: Burns, as a common type of injury in children, have many developed techniques for management of its wounds, but still have many obstacles which meet plastic surgeons. One of these is the lack of the donor sites for autogenous skin grafting especially in large body surface area burns which are unfortunately common in developing countries with limited technical and financial resources. Finding a suitable methodology to address this problem was our main hypothesis in this project. A mixed grafting technique based on using mini-autogenous skin grafts covered with large homogenous skin graft had been investigated for this purpose.Patients and Methods: This is a prospective study of 20 patients with post burn raw areas who were treated as inpatients at the Burn Unit of Assuit University Hospital, Egypt between September 2017 and September 2019. Patients were divided into two groups. Group 1 with 10 children treated by covering the wounds with mini autogenous skin grafts and skin homo grafts and group 2 with 10 children treated by the conventional autogenous skin grafts only.Results: The mean age was 6.8 ± 2.3 years, 15 males and 5 females. The mean of the harvested skin in group 1 was 1.7±0.67% vs 3.3±1.06% for group 2 (p < 0.001). Although the mean time of surgery was significantly longer for patients of group 1, these patients showed significant less bleeding from the donor site than the second group. There was non-significant difference between both groups regarding the take of the graft at the recipient site (P= 0.476). The hyperpigmentation was significantly higher among patients of group 2 (P=0.024).Conclusion: From this study we advocate the use of mini autogenous skin grafts covered with skin homografts for covering the extensive post burn raw areas in children. It provides the covering for wide raw areas in presence of shortage of the donor sites. It is a valid reliable procedure with easier and less expensive aspects suitable for developing and low-income countries where large wound burns are so common.