Experience with banked skin in the Prague Burn Center.

Despite progress in materials science, the use of human allografts and xenografts of pig origin is in the Prague Burn Center among the preferred means of temporary burn wound cover since 1973. True closure is achieved only with living autografts or isografts (identical twins). The method for preparing fresh porcine grafts was introduced in Prague 25 years ago: dermoepidermal sheets are retrieved in strips, are treated with a lavage of chemotherapeutics and antibiotics, are spread onto sterile wet gauze and stored in Pétri dishes at 4 degrees centigrade in a refrigerator. Cellular viability is maintained for 10-14 days when transferred to patients. The Prague Skin Bank commenced its activity in 1986. The Protocol for the cryopreservation of skin was established: the pretreated skin is kept in aluminium vessels in containers with vapours of liquid nitrogen. Cryoprotective Medium is used with 15% glycerol. The skin viability has been verified by investigation of glucose metabolism. The production of fresh and long-term stored viable skin grafts has been increasing continuously and at present, the production represents 2 million square centimeters per year. About 15% of the harvest is distributed to other surgical and trauma departments. Any burn wound dressing may fail due to a failure to use them properly-lack of attention to the details in burn wound care can lead to disappointment.