الفهرس 
Skin graft: Historical backgroundOnly 14 pages are availabe for public view
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Abstract
With the development of the meshed skin graft and the availability of different meshing expiation sizes, the sizes of the open areas of the meshed skin grafts interstices (gaps) are similar to all open wounds increase the metabolic needs of these patients and put them at the risk of bacterial infection.
The amniotic membrane satisfies most of the criteria for an ideal biological wound dressing. It is thin, transparent with excellent adherence properties to the wound and provides an effective barrier, a durable coverage for the wound bed, pain relief with bacteriostatic properties and rapid re-epithelization.
The aim of this study was to determine the rate of in vivo healing of the meshed skin autograft with different meshing sizes applied to post burn raw areas when covered by fresh amniotic membranes. Histological and clinical examination will determine the features of the tissues that filled the gaps (interstices) of meshed skin autografts
from October 2015 to Mars 2018, in a prospective experimental, multicenter clinical study, 45 patients in both Ain shams and Minia universities burn units with post burn raw areas (healthy granulating raw areas) and clean (non-infected).
The patients included in this study, have post burn raw areas with total body surface areas less than 30%. The patients were divided into three main groups.
-group (1):15 patients treated by meshed split thickness skin graft (1:3) only as a control group.- group (2):15 patients treated by meshed split thickness skin graft 1:3 then covered with fresh amniotic membrane
- group (3): 15 patients treated with meshed split thickness skin graft (1:6) then covered with fresh amniotic membrane
AM must be quarantined until the results of both serological tests are negative and Preservation of amnion relies on several methodologies, namely, hypothermic storage at 4 °C, usually referred simply as fresh storage
Evaluation of the Wound Healing Process.
The wound healing process evaluated on postoperative days 5, 7, 10 and 30 by photo documentation with a 8 MP camera and standardized with incisional biopsies taken from the slits (interstices) (opening windows) of the meshed STSG to assess the type of tissues formed.
At the 30th day the end result of these procedures was evaluated by POSAS (patient and observer scar assessment scale) to evaluate the formed tissues.
Both clinical and histological in this study which encourages the use of AM to sandwich meshed STSG with different meshing sizes.
AM decreased oedema in burned tissues, enhanced maturation of epithelium, increased the transformation of the newly formed capillaries into mature ones, accelerated the initiation of the proliferative phase of wound healing and promoted the re-epithelialization of the interstices of the meshed graft.AM decreased itching, one of the most annoying item in treating with burn patients. That led to a better cosmetic outcome after the use of the AM in covering meshed STSG.