Short-term storage of a patient's harvested skin is clinically desirable for numerous reasons. Previous experience in our center using a skin storage solution of saline with a high concentration of antibiotics resulted in poor graft viability and an unsatisfactory clinical outcome. This report defines an improved method of storage which allows longer storage time, yielding viable skin and results in subsequent graft acceptance on the patient. Split-thickness autografts from patients were stored in: 1) saline + 10(4) units/ml penicillin and 0.005 gm/ml streptomycin, or 2) RPMI-1640 + 25 units/ml penicillin and 25 mcg/ml streptomycin, at 4 degrees C. The pH range of the saline solution was 5.90-6.20, compared to 7.20-7.32 for the RPMI-1640 solution. The medium was changed every 3 to 4 days during the storage period. Before graft reapplication the autografts were rinsed with sterile saline. Previous clinical results using the saline-antibiotic storage solution resulted in poor graft viability and no graft survival was noted on patients after 5 days of skin storage. In contrast 11/16 autografts which had been stored in the RPMI-1640 solution for 5 to 22 days (median, 11 days) were successful takes when regrafted to patients. Graft loss was observed in five cases due to the following reasons: inability to immobilize graft (one); poor vascular bed (two); and bacterial infections (two). These data are in agreement with results reported in a separate paper, demonstrating the effectiveness of RPMI-1640 as a storage medium for maintaining viable human skin grafts which were subsequently transplanted to athymic nude mice.(ABSTRACT TRUNCATED AT 250 WORDS)