Abstract:
Introduction: For spontaneous wound healing to occur, wound preparation must be optimised. This
paper presents the authors’ experience and philosophy regarding wound bed preparation of extensive
and complicated wounds. The properties of an ideal burn dressing can be summarized in four P’s: protection, proteolytic effect, promotion of healing, and pain relieving. Glycerol preserved skin allograft
possess several key characteristics of an ideal wound bed preparation, including good adherence to the
wound bed, water vapour transport, antimicrobial characteristics, low toxicity and antigenicity, ease of
application and removal, a long shelf life, and minimal storage requirements. There are other benefits of
skin allograft application, such as decreased loss of water, electrolytes, and proteins. Skin allograft application also reduces pain and thus allows for exercise and ambulation, also decreasing the incidence of
contractures.
Methods: This study included all patients with burns and complicated wounds, who were admitted to
the Queen Fabiola Children’s University Hospital in Brussels from January 2010 to November 2010 who
had been treated with a glycerol preserved allograft. After the removal of all devitalized tissue, angiogenesis of the wound bed is promoted by the temporary application of the glycerol preserved allograft (GPA). Results The results of the study showed the high effectiveness of these kinds of treatments: infection
control, stimulation of angiogenesis, and granulation tissue formation. With the application of GPA, we
ensured that even in the extreme age group patients, such as children, their wounds were optimised for
the best chances of an allograft take at the first attempt. Otherwise, allograft failure may lead to the grave
consequence of repeated allografting with further waste of the donor sites, wound infection, sepsis, or
even mortality.
Conclusion The preserved dermal layer, even if it is thin, is crucial for spontaneous wound healing
with minimal hypertrophic scarring, due to the reduced inflammatory response in the wound bed, as
observed in our patients.
