Preservation methods of allografts and their (lack of) influence on clinical results in partial thickness burns. 2011

Michel H E Hermans
President Hermans Consulting Inc., 3 Lotus Place, Newtown, PA 18940, USA. Hermansconsulting@comcast.net

Allografts, cadaver skin and amnion membrane are considered the golden standard in the management of partial thickness burns. However, debate on whether the tissue needs to be viable is on-going, since many believe that viable grafts result in better healing. The objective of this literature survey was to analyse the evidence on the method of preservation of allografts (cadaver skin or amnion membrane, glycerol, cryopreservation, lyophilisation) having a clinical impact on the healing of partial thickness burns. The survey focussed on preservation techniques and clinical outcomes (reepithelialisation) in partial thickness burns, as well as on differences in viability, immunogenicity and antimicrobial properties of the preservation methods. Most studies on allograft treatment of partial thickness burns are observational, with only one study of a (historical) comparative nature. A true meta-analysis was not performed and the results of this survey are observational in nature as well: they indicate that there is no evidence that viability of the graft influences healing outcomes. Thus, instead of viability, other aspects, such as intrinsic antimicrobial safety of the preservation method and cost should be the primary criteria for the choice of preservation method to be used for allografts.

UI MeSH Term Description Entries
D002056 Burns Injuries to tissues caused by contact with heat, steam, chemicals (BURNS, CHEMICAL), electricity (BURNS, ELECTRIC), or the like. Burn
D005612 Freeze Drying Method of tissue preparation in which the tissue specimen is frozen and then dehydrated at low temperature in a high vacuum. This method is also used for dehydrating pharmaceutical and food products. Lyophilization,Drying, Freeze,Dryings, Freeze,Freeze Dryings,Lyophilizations
D005990 Glycerol A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, or sweetening agent. 1,2,3-Propanetriol,Glycerin,1,2,3-Trihydroxypropane,Glycerine
D006085 Graft Survival The survival of a graft in a host, the factors responsible for the survival and the changes occurring within the graft during growth in the host. Graft Survivals,Survival, Graft,Survivals, Graft
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012867 Skin The outer covering of the body that protects it from the environment. It is composed of the DERMIS and the EPIDERMIS.
D014021 Tissue Preservation The process by which a tissue or aggregate of cells is kept alive outside of the organism from which it was derived (i.e., kept from decay by means of a chemical agent, cooling, or a fluid substitute that mimics the natural state within the organism). Preservation, Tissue,Preservations, Tissue,Tissue Preservations
D014184 Transplantation, Homologous Transplantation between individuals of the same species. Usually refers to genetically disparate individuals in contradistinction to isogeneic transplantation for genetically identical individuals. Transplantation, Allogeneic,Allogeneic Grafting,Allogeneic Transplantation,Allografting,Homografting,Homologous Transplantation,Grafting, Allogeneic
D015925 Cryopreservation Preservation of cells, tissues, organs, or embryos by freezing. In histological preparations, cryopreservation or cryofixation is used to maintain the existing form, structure, and chemical composition of all the constituent elements of the specimens. Cryofixation,Cryonic Suspension,Cryonic Suspensions,Suspension, Cryonic
D016038 Skin Transplantation The grafting of skin in humans or animals from one site to another to replace a lost portion of the body surface skin. Dermatoplasty,Grafting, Skin,Transplantation, Skin,Dermatoplasties,Graftings, Skin,Skin Grafting,Skin Graftings,Skin Transplantations,Transplantations, Skin

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