Experience with the use of close-relative allograft for the management of extensive thermal injury in local national casualties during Operation Iraqi Freedom
Keywords:close-relative allograft, combat, burns
AbstractThe care of host nation burn victims in Iraq and Afghanistan has been a significant challenge to US military healthcare providers. To provide burn care in an austere environment is more challenging by limitations in resources such as inadequate medical supplies, infection control issues, and a lack of blood or tissue banking capabilities. Large full thickness burns pose a significant obstacle due to limitations in the casualties’ available donor skin, which can be used to achieve wound coverage. In US burn centers, allograft stored in skin banks provides temporary coverage during donor site healing in the management of large total body surface area burns.This report is a study of two severely burned Iraqi children with inadequate donor site surface area to achieve wound coverage that were managed with close-relative allograft harvested from their fathers to achieve temporary wound closure. A brief literature review and future recommendations are included.
Nguyen TT, Gilpin DA, Meyer NA, et al.: Current treatment of severely burned patients. Ann Surg. 1996; 223: 14-25.
Herndon DN, Barrow RE, Rutan RL, et al.: A comparison of conservative versus early excision. Therapies in severely burned patients. Ann Surg. 1989; 209: 547-552.
Hart DW,Wolf SE, Chinkes DL, et al.: Effects of early excision and aggressive enteral feeding on hypermetabolism, catabolism, and sepsis after severe burn. J Trauma. 2003; 54: 755-761.
Desai MH, Herndon DN, Broemling L, et al.: Early burn wound excision significantly reduces blood loss. Ann Surg. 1990; 211: 753-759.
Deitch EA, Wheelahan TM, Rose MP, et al.: Hypertrophic burn scars: Analysis of variables. J Trauma. 1983; 23: 895-898.
Alexander JW, MacMillan BG, Law E, et al.: Treatment of severe burns with widely meshed skin autograft and widely meshed skin allograft overlay. J Trauma. 1981; 21: 433-438.
Coruh A, Tosun Z, Oxbedit U: Close relative intermingled skin allograft and autograft use in the treatment of major burns in adults and children. J Burn Care Rehabil. 2005; 26: 471-477.
Burke JF, Quinby WC, Bondoc CC, et al.: Immunosuppression and temporary skin transplantation in the treatment of massive third degree burns. Ann Surg. 1975; 182: 183-195.
Pollock GD: Cases of skin grafting and skin transplantation. Trans Clin Soc Lond. 1871; 4: 37-54.
Girdner JH: Skin-grafting with grafts taken from the dead subject. Med Record. 1881; 20: 119-120.
Bettman AG: Homogenous Thiersch grafting as a life saving measure. Am J Surg. 1938; 39: 156-162.
Bondoc CC, Burke JF: Clinical experience with viable frozen human skin and a frozen skin bank. Ann Surg. 1971; 174: 371-382.
Welchel JD, Cosimi AB, Burke JF, et al.: Treatment of extensively burned patients with skin allografts and immunosuppression. Transplant Proc. 1975;7 (Suppl): 765.
Phipps AR, Clarke JA: The use of intermingled autograft and parental allograft skin in the treatment of major burns in children. Br J Plastic Surg. 1991; 44: 608-611.
Clarke JA: HIV transmission and skin grafts. Lancet. 1987; 1: 983.
Lundy JB, Swift CB, McFarland CC, et al.: A descriptive analysis of patients admitted to the intensive care unit of the 10th Combat Support Hospital deployed in Ibn Sina, Baghdad, Iraq, from October 19, 2005, to October 19, 2006. J Intensive Care Med. 2010; 25: 156- 162.
Kauvar DS,Wolf SE,Wade CE, et al.: Burns sustained in combat explosions in Operations Iraqi and Enduring Freedom (OIF/OEF explosion burns). Burns. 2006; 32: 853-857.
Kagan RJ, Robb EC, Plessinger RT: The skin bank. In Herdon DN (ed.): Total Burn Care, 3rd ed. Philadelphia: Saunders Elsevier, 2007: 229-238.
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