[Microskin grafting by spraying in burn management]

To explore the practicability of microskin grafting by spraying in burn management.

Razor thin autologous skin from pigs or burn patients was harvested and cut to pieces of 0.2 - 0.5 mm in size and suspended in normal saline. The suspension was put into a bottle with outlet and pumping device. The microskin suspended in the saline was sprayed to the burn wound and/or onto the alloskin sheets. The microskin distribution was detected by digital image analysis technique. In animal experiments, the burn wound development and pathomorphological changes after operation were observed. In burn patients who would receive microskin grafting, spraying method was used with the traditional flotation method as control. The treatment results and the operational procedures were compared between these two kinds of operation styles.

The microskin dispersion degree with spraying was much smaller than that with flotating method. In animal experiment with spraying method, the wound healing time was 23.2, 24.5 and 38.3 days in 3 groups, respectively, with the area ratio of donor to wound of 110, 120 and 150. In clinical study, The average operating time was 133.3 min with spraying method and 165.6 min with flotation method respectively (P < 0.05). The area ratio of donor to wound was 118.8 with spraying and 17.6 with flotation methods, respectively (P < 0.01). The one time wound coverage rate was 92.6% with spraying and 79.7% with flotation methods (P < 0.01). The wound healing time was 29.7 days with spraying and 37.3 days with flotating methods, respectively (P < 0.05).

Spraying method of microskin grafting might be a good method in major burn treatment. The advantages with this method included well-distributed microskin, simpler handling, saving of donor skin, shortening of operating time and less time needed for the wound healing. It might be recommended for other wound covering materials.