الفهرس 
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Abstract
This study aimed to evaluate the efficacy of application of epidermal autograft, in the form of spray cell suspension. In order to accelerate the wound healing process, minimize the donor site and decrease its morbidity, maximize the recipient defect benefitting from the graft procedure and achieve better scarring results. Economic affordable technique using cheaper tools and materials was advocated.
The patients were allocated into 4 groups according to assessment of the resultant scar by more than one person (including Senior Authors) with Vancouver Scar Score:
1. group 1: 5 patients whose wounds failed to heal and thus were out of assessment by Vancouver Scar Scale.
2. group 2: 7 patients developed scars that scored from 9 to 13 on Vancouver Scar Scale.
3. group 3: 6 patients developed scars that scored from 5 to 8 on Vancouver Scar Scale.
4. group 4: 2 patients developed scars that scored from 0 to 4 on Vancouver Scar Scale.
All patients were assessed in terms of:
1. Sex, age, occupation, medical history and special habits of medical importance: analyzing how these factors affected wound healing and cells acceptance.
2. Site and size of the injured area, size of donor site and how this implemented success of the procedure.
3. Duration between onset of injury and carry out of the procedure.
4. Wound contamination and suspected infection: wound swab was done to all the patients after 2 days of sterile dressings with topical antibiotics. Accordingly, patients with positive results were given systemic antibiotics specific to the organism detected in the swab result, and topical specific antibiotic was applied for 5 days to a week before carrying out the cell-spraying transplantation procedure.
Our results recorded that the patient characteristics, wound status, duration between injury and procedure and other factors were comparable between the enrolled patients.
These results suggest that cell spray technique provides a method for the preparation of a cell suspension with high viability and proliferative potential, but this technique have more than one factor affecting the healing process and quality of the resultant scar. First factor was age, especially between (7-16) years. Young patients’ transplanted cells had more vulnerability to slough and shed due to sheering movement and lesser control on mobility in the early postoperative days. Fragility of the sprayed transplanted cells could not resist in such patients leading to failure to heal.
Other factors like medical history, site of injury (peripheral/dependent/mobile/flexural), preoperative infection, and donor site size were enough reasons to worsen the subsequent scar after healing, but the most effective factors found, which must be highly considered in the future plans using this technique were smoking and large size of injury. Smoker patients with large size of injury had the greatest tendencies to form an irregular, less elastic, hypo or hyper pigmented scar, and scored the highest numbers on Vancouver Scar Scale.
Conclusion:
We can conclude that Cell Spray technique described in the present study is a step forward on the way for reconstruction of large partial-thickness skin defects. However, further larger studies are required to possibly refine the technique and improve its results.