INTERMINGLED TRANSPLANTATION OF PORCINE AND HUMAN SKIN IN EXTENSIVE BURNS

Intermingled transplantation of porcine and human skin is done in 63 extensively burned patients since 1972. After 3rd degree burn eschar excision, large sheets of partial thickness porcine skin are wrapped on the wound and autoskin inserted into the premade holes. During the first 2 weeks the porcine skin is kept viable, probably by body fluid osmosis and it is rejected by host granulation tissue growth 13-21 days afterwards. The main sites of rejection reaction are located around the heterodermal appendages and heteroepidermis. Only mild lymphocytic infiltration can be observed in the porcine collagen serving as a framework for the growing autoepithelium. Therefore if the spaces between autoskin grafts are small and the porcine hair follicles superficially seated, the wound can be eliminated by sandwiching similar to that of intermingled homo- and autoskin grafts.The overall mortality in this series is 25.5%. The average burned area of the survivors is 57.7±19.6%, with 35.45±15.68% 3rd degree burns.