الفهرس 
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Abstract
Major burn traumas are associated with increased mortalities as a result of the critical fluids and electrolytes loss and, the systemic effect of the toxic eschar that promotes an up regulation of inflammatory mediators and pro-apoptotic factors.
Skin autografts contains epidermis and a variable thickness of the dermis, which helps in healing of the remaining layers of the dermis.
Allograft possesses many positive characteristics, such as adherence, elasticity, competent of bacterial barrier, cheap, prevents desiccation of bone and tendon. It plays its rule by manipulating the microenvironment while modulating the proliferation and differentiation of spontaneous regenerating epithelium.
The aim of the study was to primarily evaluate the pathological and clinical effects of Skin Allografts from Massive Weight Loss Donors to treat Major Burn. While comparing the pathological and clinical effects of skin allografts from massive weight loss patients to non-massive weight loss patients in treating major burns. And to assess efficacy of skin allografts as compared to other temporary dressing in management of massive burns as a secondary objective.
The aim was obtained in this study which included 120 patients divided into 3 groups, each group consisted of 40 patients:
group І: (n= 40) This group included patients underwent coverage of the burned areas using Allografts from massive weight loss donors.
group П: (n= 40) this group included patients underwent coverage using Allografts from non-massive weight loss donors.
group Ш: (n= 40) this group included patients coverage using temporary dressing; AquacellTM
from our results we can conclude that:
Type of skin allograft donor does not affect the detachment day of the Allograft, yet it affects the take of the 1st dressing change.
Percentage of improvement was significantly higher among patients who used Allografts from non-massive weight loss donors when compared with patients who used Allografts from massive weight loss donors (18.35%vs 13.30% & 9.75% respectively; p = 0.023)
There was highly statistically significant difference between Photographic Wound Assessment Tool PWAT on Initial Score, Final Score and Mean difference in patients using Allografts from massive weight loss donors, patients using Allografts from non-massive weight loss donors and patients using temporary dressings (p = 0.000 for all).
Nano-crystalline silver has anti-inflammatory effects, analgesic effects and promotes wound healing by achieving better wound outcome than conventional silver preparations, and this may be even conventional dressings.