Favorable donor site for epidermal cultivation for the treatment of burn scars with autologous cultured epithelium.

It is very important to determine from where we select the donor skin for epidermal cultivation in the treatment of burn scar disfigurement. To prove this point, we compared the appearance and histology of grafted sites according to the different donor sites. Thirty-eight patients with skin color difference and irregular contours of matured burn scars were superficially abraded and underwent autologous cultured epithelial grafting. These patients were followed more than 2 years. The donor skin for epidermal cultivations was taken from the buttock (group 1, 8 patients), sole (group 2, 6 patients), and adjacent to the site of the scar (group 3, 24 patients). In group 3, skin elasticity was also measured after 2 years. Hypo- and hyperpigmentation were well treated with autologous cultured epithelial grafting. The most favorable results in terms of color match were obtained in group 3, where the skin color resembled surrounding normal skin. The skin tension returned to almost normal. In group 2, the histology of the grafted site resembled the sole epidermis. It was concluded that the general principle of conventional skin grafting (i.e., "closer is best") was also correct in cultured epithelial grafting. Furthermore, it was revealed that cultured epithelium has a site specificity even after grafting.