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 GLABROUS & NON-GLABROUS SPLIT SKIN GRAFT IN THE RECONSTRUCTION OF FLEXION CONTRACTURE OF FINGERS – AN OBSERVATIONALAND COMPARATIVE STUDY.

2020 ◽  
pp. 1-3
Author(s):  
Abhishek Gaur ◽  
Nidhi Gaur
Keyword(s):  
Skin Graft ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Flexion Contracture ◽  
Split Thickness Skin Graft ◽  
Skin Grafts ◽  
Flexion Deformity ◽  
Split Skin Graft ◽  
Thickness Skin ◽  
Split Skin

Background: Flexion contractures of the fingers cause functional and aesthetic problems to a burn patient. Various methods of reconstruction have been described in the literature. These include release and split thickness grafting, release and full thickness grafting. Among those incision or excision of the contracture band and split skin grafting were the simplest and commonest techniques. In this study, we aim to compare functional & aesthetic outcomes of glabrous & non glabrous split skin graft in flexion contracture of fingers. Methods: A total of 60 fingers of patients of post burn finger contractures were undertaken for the study. Patients were evaluated preoperatively on duration of contracture, extent of involvement, type of scar, range of movements using goniometer and degree of fixed flexion deformity. Finger contractures were released and resurfacing done with glabrous & non-glabrous split thickness skin grafts. Postoperative evaluation was done by measuring range of movements of Proximal Interphalangeal (PIP) and Distal interphalangeal (DIP) joints, flexion deformity, donor site morbidity, number of visits to the hospital, colour match of graft to adjacent skin. Results: Functional outcome in terms of active range of motion combined at DIP joint, PIP joint & metacarpophalangeal joint were similar in both glabrous split thickness skin graft & non glabrous split thickness skin graft at the end of six months. As compared with non-glabrous split thickness skin grafts, glabrous split thickness grafts provided superior colour & texture match to surround tissue. There was no significant donor site morbidity in plantar in-step area & patients were able to walk from third to fourth post operative day. There was minimal hypertrophy of plantar donor site, owing to persistent pressure in standing posture. Conclusion: Patient’s satisfaction was greater in glabrous split skin graft.

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.

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.

scholarly journals Split-thickness skin graft donor-site morbidity: A systematic literature review

Burns ◽  
2021 ◽  
Author(s):  
Malachy Asuku ◽  
Tzy-Chyi Yu ◽  
Qi Yan ◽  
Elaine Böing ◽  
Helen Hahn ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Skin Graft ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Split Thickness Skin Graft ◽  
Thickness Skin ◽  
Graft Donor

Use of Honey as an Adjunct in the Healing of Split-Thickness Skin Graft Donor Site

2003 ◽  
Vol 29 (2) ◽  
pp. 168-172
Author(s):  
AYKUT MISIRLIOGLU ◽  
SINEM EROGLU ◽  
NACI KARACAOGLAN ◽  
MITHAT AKAN ◽  
TAYFUN AKOZ ◽  
...  
Keyword(s):  
Skin Graft ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Thickness Skin ◽  
Graft Donor

scholarly journals Cografts of artificial dermis matrix and autogenetic split-thickness of repaired skin in severe hand wounds in patients with deep burns

2014 ◽  
Vol 66 (1) ◽  
pp. 173-178
Author(s):  
Hongqi Liu ◽  
Yan Li ◽  
Deqian Sha
Keyword(s):  
Wound Healing ◽  
Hand Function ◽  
Donor Site ◽  
Test Group ◽  
Healing Time ◽  
Whole Body ◽  
Control Group ◽  
Large Area ◽  
Artificial Dermis ◽  
Thickness Skin

The aim of this paper was to evaluate the effect of using artificial dermis matrix plus autologous split-thickness skin (ADM and ASTS) in the treatment of deep-burns in hands of severely burned patients?We recruited a total of 58 patients with large area burns greater than 80% that were eschar-excised. Twenty-eight of them were treated with ADM and ASTS (test group); 30 were treated with autologous medium-thickness skin (AMTS) (control group). The healing time of the hand wound was noted, clinical and photographic evaluations were performed, and a Jebsen-Taylor hand function test was compared and analyzed in the two groups. The wound healing time in the test group (24.22?3.34 days) were longer than that of the control group (13.42?3.36 days) and statistically significant. The healing time of skin graft donor sites was shorter than that of the control group (7.14?1.63 vs. 14.28?2.37 days) and statistically significant (P<0.05). The 3rd and 6th month follow-up with clinical and functional evaluations revealed no differences between the two groups. In addition, there was no obvious scar formation and less pigmentation in either group. The repair of deeply burned hands with artificial dermis matrix was beneficial to both wound healing and the donor site, and was beneficial to the whole body rehabilitation of severely burned patients.

Full Thickness Skin Graft for Nail Unit Reconstruction

2005 ◽  
Vol 30 (2) ◽  
pp. 194-198 ◽  
Author(s):  
A. LAZAR ◽  
P. ABIMELEC ◽  
C. DUMONTIER
Keyword(s):  
Skin Graft ◽  
Simple Procedure ◽  
Donor Site ◽  
Skin Grafting ◽  
Malignant Tumour ◽  
Donor Site Morbidity ◽  
Full Thickness ◽  
Full Thickness Skin Graft ◽  
Full Thickness Skin ◽  
Thickness Skin

A retrospective study of 13 patients assessed the use of a full thickness skin graft for nail unit reconstruction after total nail unit removal for nail bed malignancies. No failures of the graft were observed and no patient had recurrence of the malignant tumour at 4 year follow-up. Full thickness skin grafting is a simple procedure which provides a good cosmetic outcome and does not produce significant donor site morbidity.

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