Clinical Therapeutic Effect of Sheet Split-Thickness Skin Graft with Micropores in Repairing Third-Degree Burn Wounds on the Hands

Abstract Introduction The optimal therapy for deep burn wounds is based on the principle of rapid necrectomy and coverage in order to achieve healing that is as scar-free as possible. The available infrastructure and the patient’s condition represent limitations. With enzymatic debridement, selective bedside debridement can now be performed, however the optimal cover after enzymatic debridement has not been elucidated to date. In this study we compare superficial dermal and deep dermal wounds, which are either covered with lactic acid membrane, piscine skin, or split-thickness skin graft. To validate our approach the healed burn wounds were examined for objective (elasticity, water content, sebum, wound healing) and subjective skin quality as part of our standard follow-up care. Methods In this study, 12 patients who had received piscine skin, lactic acid membrane, or split-thickness skin graft after enzymatic debridement were retrospectively examined objectively and subjectively for scar quality as part of follow-up care 12 months after the accident. The wound healing process was also documented. Results Acceleration of wound healing was observed with the application of piscine skin vs split-thickness skin graft or lactic acid membrane. Skin elasticity was comparable to that of split-thickness skin graft but significantly better than lactic acid membrane. The sebum production in wounds treated with piscine skin was higher compared to lactic acid membrane covered wounds. The water storage capacity in the piscine skin treated wounds was also significantly higher than in lactic acid membrane or split-thickness skin graft treated wounds. Using the POSAS score, an improvement in elasticity, thickness, pigmentation, and relief was shown in piscine skin treated wounds, as well as a reduction in pain and itching, compared to split-thickness skin graft or lactic acid membrane. Conclusions The use of intact piscine skin immediately following enzymatic debridement in burn wounds results in faster wound healing and better patient outcomes compared to split-thickness skin graft or lactic acid membrane.

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Reconstruction of Deep Burn Wounds Around the Ankle With Free Fascia Flaps Transfer and Split-Thickness Skin Graft

Journal of Burn Care & Research ◽

10.1093/jbcr/irz078 ◽

2019 ◽

Vol 40 (6) ◽

pp. 763-768

Author(s):

Xuekang Yang ◽

Zhuoqun Fang ◽

Mengdong Liu ◽

Yue Zhang ◽

Qiaohua Chen ◽

...

Keyword(s):

Soft Tissue ◽

Skin Graft ◽

Burn Injury ◽

Split Thickness Skin Graft ◽

Soft Tissue Coverage ◽

Burn Wounds ◽

Temporal Fascia ◽

Thickness Skin ◽

Anterolateral Thigh ◽

Dressing Change

Abstract We aimed to introduce a technique by combining free fascia flaps transfer with split-thickness skin graft for the reconstruction of deep burn wounds at the ankle. Fifteen patients from 2009 to 2016 were enrolled in this study. Patients in this series suffered from a deep burn injury around the ankle, which was accompanied with exposure of tendon and medial or lateral malleolus exposure due to severe soft-tissue defects (N = 15). All the 15 wounds were repaired combining free fascia flaps with split-thickness skin graft operations, including nine anterolateral thigh fascia lata flaps (ATFL flaps) and six superficial temporal fascia flaps (STF flaps). All the fascia flaps completely survived. Two patients showed partial grafting skin necrosis due to either wound infection or subcutaneous hematoma infection, and this was eventually healed satisfactorily after conventional dressing change. All patients achieved esthetic outcome and acceptable functionality without further revisions needed. Our present study reports a useful method that involves using free fascia flaps in combination with split-thickness skin graft to repair deep burn wounds around the ankle. This method provided reliable and durable soft-tissue coverage with good outcomes.

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The Efficiency of Burn Wounds Debridement with Use of Hydrosurgery - Our Experiences

Polish Journal of Surgery ◽

10.1515/pjs-2015-0010 ◽

2015 ◽

Vol 87 (1) ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Marek Kawecki ◽

Karolina Mikuś-Zagórska ◽

Justyna Glik ◽

Mariusz Nowak

Keyword(s):

Skin Graft ◽

Water Jet ◽

Split Thickness Skin Graft ◽

Burn Wounds ◽

Thermal Burns ◽

Present Experience ◽

Thickness Skin ◽

Before And After ◽

Short Time ◽

Duration Of Operation

Abstractwas to present experience of doctors from the Center for Burns Treatment in Siemianowice Śląskie who use a Versajet system.. Debridement with the use of a water jet was applied in 70 patients with IIbo /IIIo thermal burns in the period between 2009-2013. The corresponding evaluation involved duration of operation, locations, wound surfaces and technique of debridement after operation. Microbiological tests were also performed before and after debridement.. In the paper, its authors draw attention to the short time of debridement. The application of a water jet allows precise debridement, particularly in hardly accessible places, preparation of wounds to be covered with autologous split thickness skin graft, protection of healthy tissues.

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Use of mesenchymal stem cells to improve healing of second degree burn wound and improve split-thickness skin graft outcome

Journal of the American Academy of Dermatology ◽

10.1016/j.jaad.2019.06.538 ◽

2019 ◽

Vol 81 (4) ◽

pp. AB144 ◽

Cited By ~ 1

Keyword(s):

Stem Cells ◽

Mesenchymal Stem Cells ◽

Skin Graft ◽

Split Thickness Skin Graft ◽

Burn Wound ◽

Graft Outcome ◽

Thickness Skin ◽

Degree Burn ◽

Second Degree

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Improving Outcomes in Anterolateral Thigh Flap Donor-Site Reconstruction Using Propeller Flaps: A Retrospective Comparative Study with Skin Grafting

Journal of Reconstructive Microsurgery ◽

10.1055/s-0040-1718550 ◽

2020 ◽

Author(s):

Domenico Pagliara ◽

Maria Lucia Mangialardi ◽

Stefano Vitagliano ◽

Valentina Pino ◽

Marzia Salgarello

Keyword(s):

Comparative Study ◽

Skin Graft ◽

Donor Site ◽

Split Thickness Skin Graft ◽

Tactile Sensitivity ◽

Aesthetic Outcome ◽

Propeller Flap ◽

Thickness Skin ◽

Anterolateral Thigh ◽

Alt Flap

Abstract Background After anterolateral thigh (ALT) flap harvesting, skin graft of the donor site is commonly performed. When the defect width exceeds 8 cm or 16% of thigh circumference, it can determine lower limb function impairment and poor aesthetic outcomes. In our comparative study, we assessed the functional and aesthetic outcomes related to ALT donor-site closure with split-thickness skin graft compared with thigh propeller flap. Methods We enrolled 60 patients with ALT flap donor sites. We considered two groups of ALT donor-site reconstructions: graft group (30 patients) with split-thickness skin graft and flap group (30 patients) with local perforator-based propeller flap. We assessed for each patient the range of motion (ROM) at the hip and knee, tension, numbness, paresthesia, tactile sensitivity, and gait. Regarding the impact on daily life activities, patients completed the lower extremity functional scale (LEFS) questionnaire. Patient satisfaction for aesthetic outcome was obtained with a 5-point Likert scale (from very poor to excellent). Results In the propeller flap group, the ROMs of hip and knee and the LEFS score were significantly higher. At 12-month follow-up, in the graft group, 23 patients reported tension, 19 numbness, 16 paresthesia, 22 reduction of tactile sensitivity, and 5 alteration of gait versus only 5 patients experienced paresthesia and 7 reduction of tactile sensitivity in the propeller flap group. The satisfaction for aesthetic outcome was significantly higher in the propeller flap group. Conclusion In high-tension ALT donor-site closure, the propeller perforator flap should always be considered to avoid split-thickness skin graft with related functional and aesthetic poor results.

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A randomized single-blind controlled study of cultured epidermal allografts in the treatment of split-thickness skin graft donor sites

Archives of Dermatology ◽

10.1001/archderm.129.7.879 ◽

1993 ◽

Vol 129 (7) ◽

pp. 879-882 ◽

Cited By ~ 9

Author(s):

T. J. Phillips

Keyword(s):

Skin Graft ◽

Controlled Study ◽

Split Thickness Skin Graft ◽

Thickness Skin ◽

Graft Donor ◽

Single Blind

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Application of a Split-thickness Skin Graft after the Removal of Huge Cutaneous Squamous Cell Carcinoma on the Right Lower Posterior Neck and Right Shoulder: Case Report

Korean Society for Head and Neck Oncology ◽

10.21593/kjhno/2016.32.1.45 ◽

2016 ◽

Vol 32 (1) ◽

pp. 45-48

Author(s):

Jong Chan Kim ◽

◽

In Pyo Hong ◽

Keyword(s):

Squamous Cell Carcinoma ◽

Case Report ◽

Cell Carcinoma ◽

Squamous Cell ◽

Skin Graft ◽

Cutaneous Squamous Cell Carcinoma ◽

Split Thickness Skin Graft ◽

Thickness Skin ◽

Posterior Neck ◽

The Right

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Reconstruction of a secondary scalp defect using the crane principle and a split-thickness skin graft

BMC Surgery ◽

10.1186/s12893-021-01056-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yi Lu ◽

Ke-Chung Chang ◽

Che-Ning Chang ◽

Dun-Hao Chang

Keyword(s):

Skin Graft ◽

Subcutaneous Tissue ◽

Donor Site ◽

Split Thickness Skin Graft ◽

Salvage Procedure ◽

Primary Defect ◽

Scalp Defects ◽

Thickness Skin ◽

Scalp Defect ◽

Secondary Defect

Abstract Background Scalp reconstruction is a common challenge for surgeons, and there are many different treatment choices. The “crane principle” is a technique that temporarily transfers a scalp flap to the defect to deposit subcutaneous tissue. The flap is then returned to its original location, leaving behind a layer of soft tissue that is used to nourish a skin graft. Decades ago, it was commonly used for forehead scalp defects, but this useful technique has been seldom reported on in recent years due to the improvement of microsurgical techniques. Previous reports mainly used the crane principle for the primary defects, and here we present a case with its coincidental application to deal with a complication of a secondary defect. Case report We present a case of a 75-year-old female patient with a temporoparietal scalp squamous cell carcinoma (SCC). After tumor excision, the primary defect was reconstructed using a transposition flap and the donor site was covered by a split-thickness skin graft (STSG). Postoperatively, the occipital skin graft was partially lost resulting in skull bone exposure. For this secondary defect, we applied the crane principle to the previously rotated flap as a salvage procedure and skin grafting to the original tumor location covered by a viable galea fascia in 1.5 months. Both the flap and skin graft healed uneventfully. Conclusions Currently, the crane principle is a little-used technique because of the familiarity of microsurgery. Nevertheless, the concept is still useful in selected cases, especially for the management of previous flap complications.

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