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The use of skin from a monozygotic twin combined with cultured epithelial autografts as coverage for a large surface area burn: a case report and review of the literature.

Definitive closure of a large burn may be a formidable task requiring a variety of techniques for success. This case report illustrates use of skin from a monozygotic twin to accomplish this goal. A 35-year-old woman ignited herself with gasoline after a domestic quarrel, which produced a burn involving 65% of her body surface area, predominantly full thickness in depth and associated with inhalation injury. After resuscitation, the patient underwent multiple burn excision procedures that used allograft coverage. Histocompatibility testing confirmed that use of her twin sister's skin was a viable strategy for burn wound closure, and ultimately, with use of this technique, the patient's anterior torso was covered. Her abdomen and anterior thighs were covered with cultured epithelial autografts, and her face and arms were autografted with the patient's donor sites. She was discharged on the one hundred sixth postburn day to a rehabilitation center. This is the fourteenth reported case of burn wound grafting with use of skin from an identical twin, and the first in which it was combined with cultured epithelial autografts. There were no adverse consequences of this procedure either for the patient or her donor twin.