Skin grafting after paediatric palmar burns: an analysis of 82 patients

2019 ◽  
Vol 44 (10) ◽  
pp. 1031-1035
Author(s):  
Evi M. Morandi ◽  
Elisabeth Schwabegger ◽  
Christoph Tasch ◽  
Gerhard Pierer ◽  
Gabriel Djedovic ◽  
...  
Keyword(s):  
Burn Injury ◽  
Case Series ◽  
Skin Grafting ◽  
Standard Of Care ◽  
Burn Injuries ◽  
Skin Grafts ◽  
Level Of Evidence ◽  
Paediatric Patients ◽  
Thickness Skin ◽  
Texture Match

Contact burn injuries to the palm are common in toddlers. We report a case series of 82 paediatric patients (age 7–48 months) with contact burn injury of the palm. We share our experience and outcomes of using plantar split-thickness skin grafts for resurfacing of the paediatric palm. We found that despite the excellent colour and texture match, split-thickness skin grafts from glabrous skin during growth are prone to motion-limiting scare contracture. From this series, we conclude that full-thickness skin grafts remain the reference standard of care in paediatric patients’ hands. We recommend that children with burn scars should have regular check-up examinations until they are fully grown. Level of evidence: IV

scholarly journals Acellular Fish Skin Grafts for Management of Split Thickness Donor Sites and Partial Thickness Burns: A Case Series

2019 ◽  
Vol 184 (Supplement_1) ◽  
pp. 16-20 ◽  
Author(s):  
Khurshid Alam ◽  
Steven L A Jeffery
Keyword(s):  
Burn Injury ◽  
Donor Site ◽  
Case Series ◽  
Skin Grafting ◽  
Viral Disease ◽  
Skin Substitute ◽  
Skin Grafts ◽  
Fish Skin ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Abstract When treating large burns, autologous skin availability becomes a problem and burn surgeons rely heavily on allogenic and xenogeneic skin for temporary coverage after excision. Application of cadaveric and pig skin grafts carries a risk of auto-immune response and risk of viral and bacterial diseases transmission, and there are many cultural and religious rejections for use of porcine grafts. There has recently become available an alternative resource of xenograft using acellular fish skin (KerecisTM Omega3 Burn). This has been described as providing an effective, safe, efficient skin substitute, free of the risk of transmission of viral disease, and auto-immune reaction risk. Methods Ten patients having split-thickness skin grafting for burn injury were treated with the fish skin xenografts. Results There were no adverse reactions noted on the use of the fish skin grafts. No patient had any reaction to the fish skin and there was a zero incidence of infection. The handling of the fish skin was excellent, a robust and pliable xenograft that was easy to apply. The quality of donor site healing was judged to be good in all cases. Both the analgesic effect noted and the relatively short average times until 100% re-epithelialization are promising. We also illustrate two cases where the dressing was used to treat superficial burns.

Expansion potential of skin grafts with novel I-shaped auxetic incisions

2021 ◽  
Author(s):  
Vivek Gupta ◽  
Arnab Chanda
Keyword(s):  
Skin Grafting ◽  
Burn Injuries ◽  
Skin Grafts ◽  
Severe Burn ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Shape Pattern ◽  
Severe Burn Injuries ◽  
Poisson's Ratios ◽  
Poisson’S Ratios

Abstract Severe burn injures lead to millions of fatalities every year due to lack of skin replacements. While skin is a very limited and expensive entity, split thickness skin grafting, which involves the projection of a parallel incision pattern on a small section of healthy excised skin, is typically employed to increase the expansion and cover a larger burn site. To date, the real expansion capacity of such grafts are low (<3 times) and insufficient for treatment of severe burn injuries. In this study, novel I-shaped auxetic incision patterns, which are known to exhibit high negative Poisson’s ratios, have been tested on the skin to investigate their expansion potential. Fourteen two-layer skin graft models with varying incision pattern parameters (i.e., length, spacing, and orientation) were developed using finite element modelling and tested under uniaxial and biaxial tensile loads. The Poisson’s ratio, meshing ratios, and induced stresses were quantified across all models. Graft models tested uniaxially along the orthogonal directions indicated opposite trends in generated Poisson’s ratios, as the length of the I-shape incisions were increased. Biaxially, with a symmetric and closely spaced I-shape pattern, graft meshing ratios up to 15.65 were achieved without overstressing the skin. Overall, the findings from the study indicated that expansion potentials much higher than that of traditional skin grafts can be achieved with novel I-shaped auxetic skin grafts, which would be indispensable for covering large wounds in severe burn injuries.

scholarly journals Reconstruction of post burns facial contractures and deformities: an Indian perspective

2018 ◽  
Vol 5 (6) ◽  
pp. 2170 ◽  
Author(s):  
Niyati Lakhani ◽  
Ashwin Lakhani
Keyword(s):  
Skin Grafting ◽  
Burn Injuries ◽  
Treatment Modalities ◽  
Skin Grafts ◽  
Full Thickness ◽  
Full Thickness Skin ◽  
Thickness Skin ◽  
Fitting In ◽  
Orbital Region ◽  
Oral Commissure

Background: Reconstruction of facial burns contracture is one of the most important surgeries in cosmetic and reconstructive surgery. This study was aimed to assess the different modalities used in facial reconstruction and their outcome.Methods: This retrospective study involved 20 patients with extensive burning facial scars. Patients were treated with different reconstructive modalities like split/full thickness skin grafts or flaps etc. Outcome of different modalities as per the area of face involved, graft taken up and complications were analyzed.Results: Majority patients were of age between 20-30 years. 72.22% patients had other associated burn injuries with facial involvement. Most patients (18, 90%) were treated after 9 months post burns duration. All patients had multiregional involvement on face but cheek being the largest unit, was most commonly involved (18, 90%) followed by involvement of oral commissure and lips in 8 (40%) and orbital region in 7 (35%) patients. Full thickness skin graft (FTSG) and split thickness skin grafts (STSG) were most commonly performed procedures. Patient with forehead scarring was treated with abdominal tube transferred in stages. Two patients with eyelid ectropion treated with release and STSG. Gillies up and down forehead flap were used for nose reconstruction due to non-availability of tissue expanders. Linear scars on chick not fitting in relaxed skin tension line were treated with excision and primary “z” plasty. Hypertrophic scar of ear was excised and STSG was applied. Common complications included hyperpigmentation and hypopigmentation, contour distortion and obliteration of labiomental sulcus.Conclusions: Facial reconstructive procedure for burns scars should be selected based on region of face involved. Skin grafting is an effective method for reconstruction especially in areas with non-availability of advanced treatment modalities.

scholarly journals A Case Series of Penile Skin Grafting in Children

2020 ◽  
Vol 08 (01) ◽  
pp. e77-e80
Author(s):  
Lin Qiu ◽  
Xuan Zhang ◽  
Yan Liu ◽  
Yuexian Fu ◽  
Xingang Yuan
Keyword(s):  
Pediatric Patients ◽  
Case Series ◽  
Skin Grafting ◽  
Skin Grafts ◽  
Penile Skin ◽  
Full Thickness Skin Graft ◽  
Thickness Skin ◽  
Scale Scores ◽  
Skin Reconstruction

AbstractPediatric penile skin grafting is rarely performed. We present a case series of four pediatric patients receiving skin grafting due to the loss of penile skin. The four boys were followed up for 1 to 5 years. One full-thickness skin graft and three split-thickness skin grafts (STSGs) survived well with low Vancouver scar scale scores. One boy gradually developed lymphedema of the distal foreskin and underwent a second preputioplasty. He presented with normal erectile function and did not experience any pain. We propose thick STSGs as the most appropriate choice for pediatric penile skin reconstruction. Lymphedema of the foreskin is an important long-term complication of penile skin grafting.

668 Fixation of Split-Thickness Skin Grafts with Liquid Adhesive and Fibrin Glue in Place of Staples

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S190-S191
Author(s):  
Joshua Frost ◽  
Nathan Hallier ◽  
Tanir Moreno ◽  
Jared Covell ◽  
Ryan Keck ◽  
...  
Keyword(s):  
Fibrin Glue ◽  
Skin Grafting ◽  
Skin Grafts ◽  
Inclusion Criteria ◽  
Intact Skin ◽  
Body Area ◽  
Wound Site ◽  
Graft Take ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Abstract Introduction A critical component of split-thickness skin grafting is the fixation of the skin graft to the wound site. Graft displacement can result in graft failure, especially during the initial 48–72 hours following application. The most common method of securing grafts is with the use of staples, sometimes with the addition of fibrin glue in order to aid both graft adhesion and homeostasis. The use of staples, however, is associated with significant levels of patient discomfort, especially during staple removal. A possible alternative to staples is the use of liquid adhesives, in combination with steri-strips, to anchor the edges of skin grafts to intact skin. Certain liquid adhesives, such as gum-based resins, are cheaper to use than staples and offer the potential to secure small split-thickness skin grafts without the associated pain of staples. In this pilot study, we examined the effectiveness of using a combination of gum-based resin (Gum Mastic-Storax-Msal-Alcohol), fibrin glue, and steri-strips to secure partial-thickness grafts in 8 patients without the use of staples or sutures. Methods Patients were included in the study who required split-thickness skin grafts to treat wounds involving less than or equal to 15% total surface body area and whose wounds were not located in areas prone to graft displacement, such as the axilla and groin. For each patient, skin grafts were secured using fibrin glue (sprayed over the entire wound), and a combination of liquid adhesive and steri-strips applied around the wound perimeter. The success of each graft was determined by the percentage of graft take. Results From January 1st, 2020 to April 30th, 2020, 8 patients were identified who fit the inclusion criteria. Five of the patients received grafts to their lower extremities, two patients received grafts to their upper extremities, and one of the patients received a graft to the torso. The average wound site that was grafted was 116.7 cm2. Average graft take among the 8 patients was 96.9%, with a range of 90%-100%. No complications at the graft site were noted, such as hematomas or any other event that resulted in graft displacement or failure. Conclusions The results of the study demonstrate that a combination of liquid adhesive, fibrin glue, and steri-strips, can be used as an effective alternative to staples in small split-thickness skin grafts. The use of liquid adhesive in place of staples was advantageous because it eliminated to need for staple removal, which resulted in less discomfort for the patient and less work for the nursing staff.

scholarly journals A cross-sectional study of long-term satisfaction after surgery for congenital syndactyly: does skin grafting influence satisfaction?

2018 ◽  
Vol 44 (3) ◽  
pp. 296-303 ◽  
Author(s):  
Bien R. Ferrari ◽  
Paul M.N. Werker
Keyword(s):  
Donor Site ◽  
Skin Grafting ◽  
Cross Sectional Study ◽  
Complication Rates ◽  
Skin Grafts ◽  
Sectional Study ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Scar Assessment

Syndactyly correction without skin grafting is advocated because it prevents graft-related complications and donor site morbidity. In this cross-sectional study, we compared satisfaction among patients who underwent correction with and without skin grafting to determine preference based on subjective and objective parameters. Retrospective chart analysis was performed among 27 patients (49 webs) who were seen at follow-up after a median follow-up period of 7.4 years, at which the Patient and Observer Scar Assessment Scale, the Withey score and a satisfaction survey were used. Notably, there were no significant differences in complication rates or observer rated scar scores. Although the need for an additional surgical procedure was higher after skin grafting, patient-rated satisfaction scores were similar irrespective of the use of grafting. Our data suggest that corrections can best be performed without skin grafts if seeking to minimize the need for an additional procedure, but that the use of skin grafts does not appear to affect patient satisfaction. Level of evidence: IV

scholarly journals Early morbidity associated with fasciotomies for acute compartment syndrome in children

2018 ◽  
Vol 12 (5) ◽  
pp. 480-487 ◽  
Author(s):  
K. B. L. Lim ◽  
T. Laine ◽  
J. Y. Chooi ◽  
W. K. Lye ◽  
B. J. Y. Lee ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Compartment Syndrome ◽  
Wound Closure ◽  
Case Series ◽  
Skin Grafting ◽  
Acute Compartment Syndrome ◽  
Inpatient Stay ◽  
Wound Infections ◽  
Short Term ◽  
Level Of Evidence

Purpose Acute compartment syndrome (ACS) requires urgent fasciotomy to decompress the relevant muscle compartment/s prior to onset of irreversible myonecrosis and nerve injury. A fasciotomy is not a benign procedure. This study aims to describe and quantify early morbidity directly associated with fasciotomies for ACS in children. Methods Clinical charts of 104 children who underwent 112 fasciotomies over a 13-year period at a tertiary children’s hospital were reviewed. The following were analyzed: ACS aetiology, fasciotomy site, number of subsequent procedures, method of wound closure, short-term complications and length of hospital stay. Results Short-term complications included wound infections (6.7%) and the need for blood transfusion (7.7%). Median number of additional operations for wound closure was two (0 to 10) and median inpatient stay was 12 days (3 to 63; SD 11.7). After three unsuccessful attempts at primary closure, likelihood of needing skin grafting for coverage exceeded 80%. Analyses showed that fasciotomy-wound infections were associated with higher risk for four or more closure procedures. Number of procedures required for wound closure correlated with longer inpatient stay as did ACS associated with non-orthopaedic causes. Conclusion Fasciotomy is associated with significant early morbidity, the need for multiple closure operations, and prolonged hospital stay. The decision for fasciotomy needs careful consideration to avoid unnecessary fasciotomies, without increasing the risk of permanent injury from missed or delayed diagnosis. Skin grafting should be considered after three unsuccessful closure attempts. Less invasive tests or continuous monitoring (for high-risk patients) for compartment syndrome may help reduce unnecessary fasciotomies. Level of Evidence Level IV, Case series

scholarly journals Minimally Invasive Technologies for Treatment of HTS and Keloids: Fractional Laser

2020 ◽  
pp. 279-285
Author(s):  
M. Tretti Clementoni ◽  
E. Azzopardi
Keyword(s):  
Minimally Invasive ◽  
Burn Injury ◽  
State Of The Art ◽  
Skin Grafting ◽  
Complex Problem ◽  
Fractional Laser ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Insight Into

AbstractThis chapter presents a state-of-the-art insight into the use of fractional laser for the management of this complex problem. In particular, we focus on the management of complex scars such as those occurring post-burn injury and split-thickness skin grafting.

Skin Grafting

2019 ◽  
pp. 65-72
Author(s):  
Stephen M. Milner
Keyword(s):  
Skin Grafting ◽  
Skin Grafts ◽  
Full Thickness ◽  
Preoperative Preparation ◽  
Scar Contracture ◽  
Skin Defects ◽  
Full Thickness Skin ◽  
Thickness Skin ◽  
Contracture Release

Skin grafting is an indispensable technique used in a variety of clinical situations, including acute burns, traumatic wounds, scar contracture release, and oncological and congenital deficiencies. The author’s preferred techniques for harvesting and resurfacing various skin defects using split- and full-thickness skin grafts are described in this chapter, together with the assessment of donor and recipient sites, preoperative preparation and postoperative considerations.

Cyanoacrylate Nail Glue and the Pajama Catalyst

2020 ◽  
Vol 41 (6) ◽  
pp. 1306-1308
Author(s):  
Harvey Rich ◽  
Jonathan J Cubitt
Keyword(s):  
Healthcare Workers ◽  
Burn Injury ◽  
Exothermic Reaction ◽  
Natural Fibers ◽  
Skin Grafting ◽  
Young Lady ◽  
Burn Injuries ◽  
Surgical Team ◽  
The Public ◽  
Online Retailers

Abstract Nail glues are routinely used for the application of false nails and are readily available for unrestricted purchase from highstreet and online retailers. We present the case of a young lady who accidentally spilled her nail glue on to her cotton pajama trouser leg setting off a violent exothermic reaction that resulted in a full-thickness burn injury to her foot. She ultimately went on to require surgical debridement and skin grafting. We intend to remind both healthcare workers and members of the public that while nail glue alone in contact with the skin is relatively harmless, contact together with natural fibers such as cotton clothing produces a dangerous chemical reaction, which is too often underestimated and can lead to serious burn injuries. Our patient and the surgical team agree that more must be done to raise awareness of the risks these products pose, and retailers must ensure consumers are responsibly informed.

Sign in / Sign up

Export Citation Format

Share Document