The Advantages And Controversies Of Allograft Skin

1551 words - 7 pages

The Advantages and Controversies of Allograft Skin
Skin is one of the most complex organs of the human bodies. Not only is it one of the largest organs contained in the human body spanning up to 22 square feet, it contains many sweat glands, blood vessels, and nerve endings. The skin on the palms of the hand and the soles of the feet is the thickest, but in most places of the body it measures about 0.10 inches thick. Human skin performs multiple functions. Not only does it form barriers against both internal and external pathogens in the environment, it contains many nerve endings that interpret both heat and cold vibration. Skin regulates heat loss, helps prevent water loss, and ...view middle of the document...

Burns can develop into more pronounced ones because of the agents in the chemicals, and how long they take to react to the skin. Swelling and blisters occur after a major burn when skin loses its elasticity. Skin then tightens and shrinks, and produces scar tissue. Without skin, a human loses their natural covering. Therefore, a burn patient needs antibiotics and bandages to form a temporary covering for the skin. A patient also needs to be kept in an atmosphere that is free from germs. Anyone entering their room needs to wear a gown and mask. In addition, anything touching the patient has to be sterilized to avoid infection. Following a massive burn, dead tissue needs to be removed by a debriding agent such as papain-urea. Debridement is performed in a tank from one to two times a day to provide a smooth surface for skin implants. Cindy Broaddus (a chemical burn survivor) states in her text “A Random Act,” Each morning I wake up, get a dose of morphine…head to the tank room for daily, sometimes twice a day, debridement. As you might imagine, there is no gentle way to take skin off. I am one giant blister...rubbing them raw is unbearable” (71). Early removal of dead tissue, followed by grafting is optimal for the patient in terms of less blood loss and a shorter stay in the hospital. However sometimes surgical debridement is a choice preferred by some doctors to remove all dead tissue down to living tissue in one procedure. If burns cover a large percentage of the body, patients can die if thermoregulation to the skin cannot be maintained. The use of allograft skin following surgical debridement is controversial to some in that allograft skin does not contain blood vessels, or hair follicles. However, the use of allograft skin in full thickness injuries, combined with a host dermis can be permanent composite skin substitute. Allograft skin is available up to 0.020 inches to achieve a thick autograft, without material thickness, and offers less of a rejection rate compared to thicker autografts. A primary goal in the use of biologic skin is to provide the patient with a graft that aids in faster healing, and provides a smoother cosmetic appearance. But the optimal goal is to provide a skin graft that provides a matrix that doesn’t degrade to early as to expose new host skin tissue.
Biological grafts are skin that is already made. Grafts in this category are allograft (cadaver skin) and xenograft (porcine derived graft). Skin grafts from deceased donors are harvested most often from the back, abdomen and the legs. The entire surgical procedure takes about two hours. Allograft skin is most often preserved by cryopreservation. Some opponents argue that allograft skin is not as readily available as xenograft skin. However, allograft skin is more pliable, and causes less drainage at the wound site. Both grafts in this category do not contain blood supplies; therefore they need blood vessels to grow into them. Once skin...

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