scholarly journals Surgical Management of Post Burn Hand Deformities

2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Suneel Kumar ◽  
Faisal Akhlaq ◽  
Hyder Ali ◽  
Saba Kiran
Keyword(s):  
Surgical Management ◽  
Surgical Procedures ◽  
Skin Graft ◽  
Health Science ◽  
Split Thickness Skin Graft ◽  
Creative Commons ◽  
Thickness Skin ◽  
Hand Deformities ◽  
Contracture Release ◽  
Burn Hand

Objective: To evaluate the efficacy of different surgical procedures on post burn contracture of hand. Methods: A quasi-experimental study design was conducted at the Department of Plastics and Reconstructive Surgery, Dow University of Health Science, DR. Ruth KM Pfau, Civil Hospital, Karachi, Pakistan from 1st June 2019 to 30th November 2019. Ninety-three participants of burned hand contracture of either gender, aged between 6- 60 years were included in the study. Resurfacing surgery with skin graft and loco-regional flaps were done according to type of contracture with individualization for each patient. All patients were kept under follow up for ninety days to assess efficacy of contracture release for each surgical procedure was noted. SPSS version 23 was used to analyse data. Results: Full thickness skin graft (FTSG) was performed in 60.2% cases, 17.2% with split thickness skin graft (STSG) and 12.9% with cross finger flaps. About 25% of recurrence was observed in cross finger flaps, whereas no recurrence was seen in Z-plasties and posterior interosseous flap. The significant association was between recurrence and surgical procedures (p<0.05). Conclusion: Z-plasty followed by FTSG was effective in the management of post burn contractures of hand. doi: https://doi.org/10.12669/pjms.36.6.2206 How to cite this:Kumar S, Khan FAA, Ali H, Kiran S. Surgical Management of Post Burn Hand Deformities. Pak J Med Sci. 2020;36(6):---------.  doi: https://doi.org/10.12669/pjms.36.6.2206 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Study of soft tissue reconstruction in postburn flexion contracture of the hand

2021 ◽  
Author(s):  
Nagaraj Gareikpatii
Keyword(s):  
Flexion Contracture ◽  
Burn Injuries ◽  
Split Thickness Skin Graft ◽  
Soft Tissue Reconstruction ◽  
Thickness Skin ◽  
Contracture Release ◽  
Tissue Reconstruction ◽  
Thermal Injuries ◽  
Electrical Burns ◽  
Burn Hand

Background: Burn contracture of the hand can leave patients with severe functional and psychological limitations. This study evaluates the severity of the deformity and various reconstructive options in post-burn hand injuries.Methods: This work includes the study of 50 patients who underwent reconstruction for post-burn flexion contracture of the hand, including fingers, in the department of plastic surgery. The patients were treated between April 2007 to April 2009.Results: Males were more commonly affected by burn injuries and thermal burns were more common than electrical burns. The little finger showed higher involvement and contracture release followed by grafting was the commonly done reconstructive procedure.Conclusions: Split thickness skin graft (SSG) were more effective in reconstruction in thermal injuries, while cross finger flaps (CFF) showed more promise in electrical injuries of the hand. 

scholarly journals Correction of Hand Deformities after Burn

2021 ◽  
Author(s):  
Daegu Son
Keyword(s):  
Skin Graft ◽  
Hand Function ◽  
Donor Site ◽  
Flexion Contracture ◽  
Thickness Skin ◽  
Hand Deformities ◽  
Web Space ◽  
Hand Burns ◽  
Burn Hand ◽  
Skin Contractures

Hand burns can lead to deformities even after successful primary healing. They are the most common cause of skin contractures involving the hand. This review article discusses ways to correct claw deformity, flexion contracture in palm and finger, and web space contracture, which are post-burn hand deformities commonly encountered in clinical practice. Loss of skin is the end result in many causes of hand deformities after burn. Therefore, reinforcing the lost skin is the principle of corrective surgery. Even if the skin is thicker than the full-thickness skin, it will engraft if damage to the tissue and blood vessels of the recipient is minimized. The thicker the skin, the less is the re-contraction and growth. The foot is an ideal donor site for skin graft on the hand. In particular, the instep or the area below the malleolar is a very good donor site. First web space of the hand is very important for hand function, and it must be reconstructed with Z-plasty, skin graft, and free flap step by step according to the degree of contraction.

scholarly journals Surgical management of dissecting cellulitis of the scalp using free latissimus dorsi flap and meshed split–thickness skin graft

Medicine ◽  
2021 ◽  
Vol 100 (4) ◽  
pp. e24092
Author(s):  
Nicoleta-Sara Baneu ◽  
Vlad Adam Bloancă ◽  
Diana Szilagyi ◽  
Patricia Cristodor ◽  
Alexandru Pesecan ◽  
...  
Keyword(s):  
Surgical Management ◽  
Skin Graft ◽  
Latissimus Dorsi ◽  
Latissimus Dorsi Flap ◽  
Split Thickness Skin Graft ◽  
Thickness Skin ◽  
Free Latissimus Dorsi Flap

scholarly journals Surgical management of a hand extravasation of anthracycline at late presentation

2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Komla Sena Amouzou ◽  
Nabil Berny ◽  
Tiemoko Moulaye Haidara ◽  
Abdessamad Chlihi ◽  
Mohamed Ezzoubi
Keyword(s):  
Breast Cancer ◽  
Soft Tissue ◽  
Surgical Management ◽  
Skin Graft ◽  
Tissue Damage ◽  
Late Presentation ◽  
Split Thickness Skin Graft ◽  
Thickness Skin ◽  
Deep Ulceration ◽  
Anthracycline Extravasation

<p>Anthracycline extravasation remains a feared serious complication of chemotherapy. At late presentation, deep ulceration and extensive soft tissue damage are seen. Hand extravasation of anthracycline may lead to tendon and nerves destruction with functional and economical impairments. We report a case of Epirubicin extravasation seen at day 25 in a 46-year-old woman treated for breast cancer. A groin flap failed due to the persistence of anthracyclin in the wound. A split thickness skin graft was done after all the tendons were removed. The chemotherapy was interrupted for two months. Wide serial debridements are needed to achieve the removal of all molecules of anthracycline that are observed when granulating tissue is observed permanently in the wound.</p><p> </p>

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

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.

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

BMC Surgery ◽  
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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