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 itswounds, but still have many obstacles which meet plasticsurgeons. One of these is the lack of the donor sites forautogenous skin grafting especially in large body surface areaburns which are unfortunately common in developing countrieswith limited technical and financial resources. Finding asuitable methodology to address this problem was our mainhypothesis in this project. A mixed grafting technique basedon using mini-autogenous skin grafts covered with largehomogenous skin graft had been investigated for this purpose.Patients and Methods: This study is a prospective studyof 20 patients with post burn raw areas who were treated asinpatients at the Burn Unit of Assiut University Hospital,Egypt between September 2017 and September 2019. Patientswere divided into 2 groups. Group: 1 with 10 children treatedby covering the wounds with mini autogenous skin grafts andskin homo grafts and Group: 2 with 10 children treated bythe conventional autogenous skin grafts only.Results: The mean age was 6.8±2.3 years, 15 males and5 females. The mean of the harvested skin in group 1 was1.7±0.67% vs. 3.3±1.06% for group 2 (p < 0.001). Althoughthe mean time of surgery was significantly longer for patientsof group 1, these patients showed significant less bleedingfrom the site of the donor than the 2nd group. There werenon-significant differences between both groups regardingthe take of the graft at the recipient site (p=0.476). Thehyperpigmentation was significantly higher among patientsof group 2 (p=0.024).Conclusion: From this study we advocate the use of miniautogenous skin grafts covered with skin homografts forcovering the extensive post burn raw areas in children. Itprovides the covering for wide raw areas in presence ofshortage of the donor sites. It is a valid reliable procedurewith easier and less expensive aspects suitable for developingand low-income countries where large wound burns are socommon.No specific grants were received by this research fromfunding agencies in the commercial, public, or not-for-profitsector.