ObjectiveTo investigate the application of transplantation with allogeneic acellular dermis and autologous epidermal skin graft combined with comprehensive rehabilitation to scar repair in the patients with late-stage extraordinarily large area burn when skin source deficiency. MethodsEighteen late-stage extraordinarily large area burn patients complicated with hypertrophic scar, contracture and deformity were enrolled and suffered skin source deficiency. The patients received preoperative rehabilitation including pressure, stretching, and joint loosening. Wound repair was conducted by removal and release of scar, transplantation with allogeneic acellular dermis and autologous epidermal skin graft after plateau. Continuous comprehensive rehabilitation was conducted after operation, including joint mobilization, pressure therapy and braces. ResultsThe wound was healed in all the 18 patients, and the average duration for healing was 13 days. Early interventional rehabilitation was performed after operation. The duration of follow-up was 6-12 months. The wound with good color and texture and mild recontracture was observed. No recurrence occurred in the wound. The dysfunction was significantly improved. No scars was found in the donor site, thus skin grafts could be obtained repeatedly. ConclusionFor the repair of late-stage extraordinarily large area burn complicated with scar contracture and deformity under the condition of skin source deficiency, transplantation with allogeneic acellular dermis and autologous epidermal skin graft combined with comprehensive rehabilitation not only enables the skin of recipient site to obtain good texture, smooth appearance, mild contracture and improved function, but also enables the donor site to supply skin repeatedly, thus creating multiple opportunities of repair for the patients with deficiency of skin sources.

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