scholarly journals Ten-year Follow-up After Treating Extended Burn Scar Contracture with an Autologous Cultured Dermal Substitute

2018 ◽  
Vol 6 (6) ◽  
pp. e1782 ◽  
Author(s):  
Takashi Nuri ◽  
Koichi Ueda ◽  
Yasushi Fujimori
Keyword(s):  
Dermal Substitute ◽  
Burn Scar ◽  
Scar Contracture ◽  
Cultured Dermal Substitute

644 Use of Plantar Foot Plate Splints and High-Profile Leg Net Devices for Prevention of Plantarflexion Contracture following Placement of Cultured Epidermal Autograft to Lower Extremities

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S178-S179
Author(s):  
Brooke Dean ◽  
Gregory Andre ◽  
Scott F Vocke
Keyword(s):  
Lower Extremity ◽  
Burn Injury ◽  
Lower Extremities ◽  
Ankle Dorsiflexion ◽  
Burn Scar ◽  
Thermoplastic Material ◽  
Scar Contracture ◽  
High Profile ◽  
Left Ankle

Abstract Introduction Burn Therapists strive to prevent burn scar contracture through positioning strategies beginning in the acute phase of burn injury. This task is even more challenging when paired with posterior offloading and joint immobilization required for the viability of cultured epidermal autograft (CEA). High profile leg net devices are the standard for posterior offloading after application of CEA circumferentially to lower extremities but can result in poor positioning of the ankle. Custom foot plate splints were designed and fabricated to preserve ankle dorsiflexion during the initial stages of CEA healing. Methods The high-profile leg net devices were assembled using 3/4 inch PVC piping and PVC fittings (45 degrees, 90 degrees, and tees) with double layered elastic tubular netting to allow proper wound ventilation while supporting the lower extremity with the patient in supine. The plantar foot plates were custom molded to the patient’s foot using thermoplastic material and lined with medium density temper foam for pressure relief. The foot plate was attached to the frame using Velcro and straps. Instructions with photographs were posted in the patient’s room for nursing staff to reference. Netting was exchanged daily and frames were disinfected using standard techniques. Results Goniometric measures were taken for ankle dorsiflexion were taken on day of CEA application with lower extremities positioned on high profile nets (in alignment with cutaneous functional unit modified position): -6 degrees right ankle, -2 degrees left ankle. Repeat measures were taken after one week period of bilateral lower extremity immobilization per CEA protocol: -1 degree right ankle, 2 degrees left ankle. One month follow-up at the discontinuance of leg net devices showed bilateral ankle dorsiflexion preserved with 3-degree right ankle dorsiflexion and 5 degrees on the left. Conclusions The use of custom foot plates on high profile leg net devices appears to improve ankle dorsiflexion range of motion while maintaining adequate posterior offloading required for CEA precautions for a burn survivor with extensive lower extremity burn wounds.

312 Retrospective Analysis of Long-Term Scarring Outcomes in Paediatric Burns Patients

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Mistry
Keyword(s):  
Outcome Measure ◽  
Patient Reported Outcome ◽  
Burn Patients ◽  
Burn Scar ◽  
Common Presentation ◽  
Paediatric Burns ◽  
Significant Difference ◽  
Patient Reported

Abstract Introduction Paediatric burns are a common presentation to a plastic surgery unit. The long-term scar outcomes in paediatric burns patients are relatively unknown as most are discharged after 6 weeks follow up. We aimed to determine whether the long-term scarring outcomes are significantly different in those who had surgical treatment with Versajetâ debridement and Biobraneâ, versus those treated conservatively with non-adherent dressings, in a cohort of paediatric burns patients. Method The parents of all paediatric burns patients admitted to Stoke Mandeville Hospital from October 2014 to September 2017 were contacted by telephone to fill in the Brisbane Burn Scar Impact Profile (BBSIP), a patient reported outcome measure specifically aimed at children. The results from the questionnaires underwent statistical analysis to see if there was a significant difference in questionnaire scores between children treated surgically versus those treated conservatively. Results A total of 107 children were admitted in the timeframe, responses were received from 34 patients with 13 having been treated surgically and 21 having been treated conservatively. In all 58 questions that make up the BBSIP, there was no statistically significant difference observed in the scores of those treated surgically versus those treated conservatively. For 31 questions on the BBSIP, the lowest score indicating the best outcome was observed in all patients in both groups. Conclusions We found no statistically significant difference in the long-term scar outcomes as assessed by the BBSIP in paediatric burn patients treated with Versajetâ debridement and Biobraneâ, versus those treated conservatively with non-adherent dressings.

scholarly journals The neck burn scar contracture: a concept of effective treatment

2017 ◽  
Vol 5 ◽  
Author(s):  
Sadanori Akita ◽  
Kenji Hayashida ◽  
Satoshi Takaki ◽  
Yoshihisa Kawakami ◽  
Takuto Oyama ◽  
...  
Keyword(s):  
Wound Healing ◽  
Growth Factor ◽  
Surrounding Tissue ◽  
Burn Scar ◽  
Scar Contracture ◽  
Accelerate Wound Healing ◽  
Epigastric Artery ◽  
Basic Fibroblastic Growth Factor ◽  
Extensive Burns ◽  
Reconstructive Methods

Abstract A neck scar contracture can severely and negatively affect the function of mastication, phonic, or breathing and result in neck pain and issues with esthetics. The best way is of course to avoid such contracture by means of non-surgical treatment such as use of a growth factor. The basic fibroblastic growth factor is clinically well proven in decreasing scar formation and improving healing. There are numerous reconstructive methods for neck contracture, especially when the lesions are relatively limited in part of the neck. However, a very severe and full circumferential scar contracture requires extensive reconstruction. The thin groin flap is one of the answers and well matches with the tissue texture and maintains the flexibility. Even with extensive burns and delayed reconstructions due to resuscitation first, the groin area is well preserved and can be safely harvested by dual vasculature systems of the superficial circumflex iliac artery and superficial epigastric artery, which warrant more reliability compared to the perforator flaps in this area. More demanding and stringent forms of the neck burn scar contracture are the sequelae of radiation. A radiation burn or radiation injury can be progressing and hard to heal. Adipose-derived stem cells can reverse the scar contracture as the surrounding tissue is softened and can accelerate wound healing. In this review, different types of neck burn scar contracture and reconstructive methods are summarized, including innovative use of bFGF and ADSCs in the management of difficult wound healing and scar contracture.

028 
Clinical Trials of Allogenic Cultured Dermal Substitute for the Treatment of Burn Wounds

2004 ◽  
Vol 12 (1) ◽  
pp. A12-A12
Author(s):  
Morotomi Tadaaki ◽  
Kamiishi Hiroshi ◽  
Kubo Kentaro ◽  
Matsui Hiromichi ◽  
Kagawa Shizuko ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Dermal Substitute ◽  
Burn Wounds ◽  
Cultured Dermal Substitute

scholarly journals Profile of Patients Without Burn Scar Contracture Development

2017 ◽  
Vol 38 (1) ◽  
pp. e62-e69 ◽  
Author(s):  
Reg Richard ◽  
Alexis R. Santos-Lozada ◽  
W. Scott Dewey ◽  
Kevin K. Chung
Keyword(s):  
Burn Scar ◽  
Scar Contracture

A Comparative Study of the Heterodigital Neurovascular Island Flap in Thumb Reconstruction, with and without Nerve Reconnection

1994 ◽  
Vol 19 (5) ◽  
pp. 552-559 ◽  
Author(s):  
R. ADANI ◽  
P. B. SQUARZINA ◽  
C. CASTAGNETTI ◽  
A. LAGANÁ ◽  
G. PANCALDI ◽  
...  
Keyword(s):  
Donor Site ◽  
Functional Results ◽  
Flap Reconstruction ◽  
Hypertrophic Scarring ◽  
Digital Nerve ◽  
Thumb Reconstruction ◽  
Cold Intolerance ◽  
Scar Contracture ◽  
Sensory Acuity

41 heterodigital neurovascular island flaps were used to cover defects of the tactile pad of the thumb in 17 years. With an average follow-up of 75.5 months, 30 patients were reviewed. 17 were treated by the original Littler technique and 13 were treated with the same flap reconstruction but with division of the digital nerve innervating the flap and re-anastomosis of this nerve to the proximal nerve end of the ulnar digital nerve of the thumb. Good aesthetic and functional results were achieved in both groups. Sensory acuity did not appear to decrease with time. The nerve reconnection technique solves the “double sensibility” phenomenon (present in 41.1% of our cases treated by the original technique), but two-point discrimination is less than that achieved by the Littler technique. Most complaints were related to the donor site such as hypertrophic scarring or scar contracture and cold intolerance, but these did not cause any real functional impairment.

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