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ORIGINAL ARTICLE
Year : 2019  |  Volume : 32  |  Issue : 2  |  Page : 717-722

Deantigenicity of skin homografts in management of major burn cases


1 Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Plastic and Reconstructive Surgery, El-Materia Teaching Hospital, Cairo, Egypt

Correspondence Address:
Ezzat AM Allam
Zagazig City, Skarkia Governate
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_851_17

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Objective The aim was to assess the ability of deantigenicity of skin homograft to decrease its rejection and improve its survival in management of patients with major burns. Background Skin homograft is considered as a good skin substitute in major burn cases. The major problem of the skin homograft is rejection. So, many methods are used to decrease antigenicity of the skin homograft and prolong its survival. Patients and methods This clinical trial included 32 patients with burn who were managed in Plastic Surgery Department, Menoufia University Hospital, from October 2015 to October 2017. Four groups were formed: control group had nine patients without deantigenicity of the homograft; group A had seven patients with freezing of the skin homograft at 4°C; group B had eight patients with skin homograft applied for irradiation; and group C had eight patients, with the recipient patient receiving dexamethasone injection. After escharotomy and coverage with skin homograft, follow-up was done for rejection of the homograft clinically. Results In the control group, the mean percentage of rejection of homograft was 62.22 ± 12.01%. In group A, the mean percentage of rejection was 61.4 ± 10.6%, with P value of 0.9. In group B, the mean percentage of rejection was 21.8 ± 10.69%, with P value of less than 0.001. In group C, the mean percentage of rejection was 48.7 ± 15.07%, with P value of 0.036. Conclusion Local irradiation dose to the skin homograft can minimize its rejection. Systemic corticosteroids produce less effect regarding the rejection of skin homograft when used with the usual dose, but with increasing dose, the rejection decreased. Freezing of the skin homograft in 4°C has no significant effect on the rejection of the skin homograft.


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