OBJECTIVEIntroducing a comprehensive technique to reconstruct burn scar contracture or deformities using integra (artificial dermis) with large epidermal skin grafting or ulth-thin split-skin.

METHODSThe wounds following contracture scar or deformities excised or loose were covered with the integra which was flattened and fixed perfectly, after a 2 approximately 4-week period, the out layer was removed then covered with large sheets of epidermal grafts, which was of thickness from 0.0028 inc to 0.0048inc (0.07 approximately 0.12 mm), or ulth-thin split-skin of about 0.006inc (0.15 mm) thickness, harvested using the electric or air power dermatome, the edge of the graft sheet attached together with the borders of wound using nanoparticles-Ag-gauze stripe adding sutures of the 5-0 threads or the skin stapler, dressed with vaseline gauzes in the inner layer and the nano-particles Ag gauze on the outer surfaces.

RESULTSNineteen sites of 15 cases including 5 sites in trunk and 14 sites in extremities from 1999.8 to 2003.6 were treated using this technique in this study, the wound areas following scar excised was about 10 cm x 25 cm approximately 30 cm x 75 cm, of them 12 cases covered with a large sheet of ultr-thin split-skin (in early time) and 7 cases with a large sheet of epidermal grafting and all of them was survival. The colour and texture of the reconstruction sites were very good and can be compared favorably with normal skin after a half year-four year following up period, because all donor sites healing without scarring, the appearance in the epidermal graft donor is better than that in split-thickness skin donor.

CONCLUSIONSIntegra with large sheets of epidermal grafts applied for scar contracture disformities is an effective and useful method, especially the epidermal grafts offered a satisfying result in the donor healing.