الفهرس 
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Abstract
Burn is one of the most common traumas worldwide and it
represents a complicated problem in its management because of the
complicated pathology and very difficult and highly demanding lines of
treatment.
As the early excision and coverage of burn wound become an
integral part in treatment of deep dermal and full thickness burn and as we
don’t have skin banks in Egypt and because skin substitutes are highly
expensive, we recommend the use of live sibling skin homograft as a very
good skin substitutes which is priceless and easily harvested. The skin
homograft can play an important part in the management of burn patients
especially major burn with limited donor site.
The main problem of the skin homograft is the rejection and loss
after a limited time of application as the skin represents the most antigenic
organ in the body. So, in this study we offer a method to decrease the
rejection and loss of skin homograft by using combined homograft and
autograft to cover burn area in major burn cases with limited donor site
for autograft in order to get too much benefit for the patient as much as
possible. We made a comparison between use of combined homograft and
autograft and use of homograft only in major burn cases regarding
mortality, hospital stay, time of start rejection, percentage of rejection,
need for another session of graft.
This study include 54 freshly burned patients received their
management in burn unit in plastic surgery department of Menoufia
university hospitals.
In conclusion of this study, we found that using combined
homograft and autograft is superior to use of homograft only regarding
morbidity, hospital stay, need for another session of graft with increase in
time before start of graft rejection and decrease in percentage of graft
rejection so we want to recommend the use of combined graft as an
important part of management of major burn cases with lack of donor site
for autograft. Combined graft is priceless and does not need special
complicated methods for harvesting, preparation and preservation.