scholarly journals Plaštakų nudegimų gydymo metodų lyginamoji studija

2004 ◽  
Vol 2 (3) ◽  
pp. 0-0
Author(s):  
Kęstutis Maslauskas ◽  
Rytis Rimdeika ◽  
Jolita Rapolienė ◽  
Tarvilas Norkus ◽  
Žilvinas Saladžinskas ◽  
...  
Keyword(s):  
Burn Injury ◽  
Skin Grafting ◽  
University Hospital ◽  
Wrist Flexion ◽  
Burn Treatment ◽  
Control Measurement ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Flexion Extension ◽  
Group A

Kęstutis Maslauskas1, Rytis Rimdeika1, Jolita Rapolienė3, Tarvilas Norkus1, Žilvinas Saladžinskas2, Paulius Karčauskas31 Kauno medicinos universiteto klinikųChirurgijos klinikosPlastinės ir rekonstrukcinės chirurgijos skyrius2 Kauno medicinos universiteto klinikųChirurgijos klinika3 Kauno medicinos universitetas,Eivenių g. 2, LT-50009, KaunasEl paštas: [email protected] Įvadas KMUK Chirurgijos klinikos Plastinės chirurgijos ir nudegimų skyriuje (2001 01–2004 06) atliktas randomizuotas atsitiktinių imčių tyrimas, kuriuo lyginti du gydymo metodai. Ligoniai ir metodai Traukiant vokus pacientai suskirstyti į grupes. Patekusiems į A grupę pacientams per 7 paras nuo nudegimo atliekama nekrektomija ir dalies storio autodermoplastika. Pacientams, patekusiems į B grupę, atliekami perrišimai vartojant sidabro sulfadiaziną, o atsidalijus negyvybingiems audiniams, – autodermoplastika. Iš stacionaro pacientai išrašomi sugijus >95% žaizdų. Kontrolės metu tiriami pirštų ir riešo aktyvūs ir pasyvūs judesiai, matuojama pirštų ir plaštakos jėga. Tirta 71 nudegusios plaštakos funkcija (44 pacientai). Rezultatai Lygindami minėtų grupių pacientų riešo judesius nustatėme, kad riešo judesių amplitudė atliekant fleksinius, ekstenzinius judesius, radialinis ir ulnarinis nuokrypis buvo didesni A grupės. Palyginus nykščio metakarpofalanginių ir interfalanginių sąnarių fleksinių judesių amplitudę bei ekstenziją per interfalanginius sąnarius, taip pat nykščio atitraukimą ir opoziciją išsiaiškinome, kad statistiškai reikšmingai geresnė funkcija buvo A (ankstyvos plastikos) grupės. Nustatėme statistiškai reikšmingą skirtumą lygindami visų pirštų fleksinius judesius per metakarpofalanginius, proksimalinius interfalanginius ir distalinius interfalanginius sąnarius. Lygindami ekstenzinius judesius per sąnarius, statistiškai reikšmingo skirtumo negavome. Pirštų ir plaštakų jėga buvo didesnė ankstyvos nekrektomijos ir plastikos, t. y. A, grupėje. Išvados Plaštakų nudegimą gydant ankstyva nekrektomija ir plastika, žaizdos sugyja greičiau, atkuriama didesnė riešo ir pirštų judesių amplitudė, plaštakos jėga, sutrumpėja paciento gydymo ligoninėje trukmė ir sumažėja gydymo išlaidos. Reikšminiai žodžiai: plaštakų sužalojimas, nudegimas, nekrektomija, plastika Comparative study of hand burn treatment Kęstutis Maslauskas1, Rytis Rimdeika1, Jolita Rapolienė3, Tarvilas Norkus1, Žilvinas Saladžinskas2, Paulius Karčauskas3 Objective During the period 01.2001–06.2004 in the Unit of Plastic Surgery and Burns of Kaunas Medical University Hospital a prospective randomised clinical trial was performed to compare two methods of treatment. Patient and methods Patients were selected into two groups by the envelope method. For patients in group A, necrectomy and immediate split thickness skin grafting were performed during the first 7 days after burn injury. In group B, daily local applications of silversulfadiazine and escharectomy with delayed split thickness skin grafting were performed. Patients were discharged from hospital when wound healing more than 95% was achieved. During the control, measurement of movements of all wrist and finger joints was performed. Also, the power of fingers and of all hand was measured. We examined 71 burned hands (44 patients). Results Comparing wrist flexion, extension, ulnar and radial deviation we found that the amplitude of movements was statistically significantly better in group A. Thumb flexion, extension, abduction and opposition were also better in the early necrectomy group. Conclusions The amplitude of movements of metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints as well as the strength of fingers and hands were statistically better in group of early necrectomy with immediate split thickness skin grafting. Keywords: hand burns, hand injuries, grafting, early grafting

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.

scholarly journals Comparison of the effectiveness of Ropivacaine soaked vs bupivacaine soaked dressing for pain relief at split thickness skin graft donor site.

2020 ◽  
Vol 27 (09) ◽  
pp. 1952-1957
Author(s):  
Abdul Malik Mujahid ◽  
Farrukh Aslam Khalid ◽  
Kashif Mehmood Sheikh ◽  
Muhammad Sheraz Raza ◽  
Husnain Khan ◽  
...  
Keyword(s):  
Pain Relief ◽  
Rating Scale ◽  
Donor Site ◽  
Skin Grafting ◽  
Tissue Loss ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Group A ◽  
The Mean ◽  
Group B

Objectives: To compare the mean pain score of ropivacaine soaked dressing versus bupivacaine-soaked dressing for pain relief at the donor site among patients requiring split thickness skin grafting after burns and tissue loss. Study Design: (RCT) Randomized control trial. Setting: Department of Plastic Surgery Jinnah Burn and Reconstructive Surgery Center Lahore. Period: January 1, 2019 to June 31, 2019. Material & Methods: Total 120 patients meeting the inclusion criteria were enrolled and divided randomly into Group-A and Group-B based on lottery method. Group A was dressed with ropivacaine soaked dressing while group-B with bupivacaine-soaked dressing. Patients were asked about pain four hours after the dressing using the verbal rating scale of 0-10. Result: Total 120 patients were included and randomly divided in to two groups. The mean age of ropivacaine group (Group A) patients was 40.82±13.20 years and bupivacaine group (Group-B) patients was 39.70±12.20 years. 56(46.67%) patients were males and 64(53.33%) patients were females.  Male to female ratio was 0.8:1. The mean size of the defect for Group-A patients was 10.43±2.92 and Group B patients was 10.13±2.91. The Mean Visual Rating Scale (VRS) at the baseline for ropivacaine was 7.95 ± 1.04 and for bupivacaine was 8.0167 ±.791 (p =0.695) and VRS (verbal rating scale) at 4 hours of ropivacaine group patients was 1.27±1.13 and in bupivacaine group patients was 2.58±1.61. The statistically significant difference is found between the two study groups for VRS at 4 hours (p-value=0.001). Conclusion: Ropivacaine soaked dressing showed significantly better outcome than bupivacaine-soaked dressing at the donor site among patients requiring split thickness skin grafting after burns and tissue loss.

Split-thickness skin graft of a pedal oil burn in an adolescent female

1991 ◽  
Vol 81 (8) ◽  
pp. 435-439 ◽  
Author(s):  
ME Leen ◽  
M Feldman ◽  
S Schoenberger ◽  
KC Chae
Keyword(s):  
Burn Injury ◽  
Skin Grafting ◽  
Split Thickness Skin Graft ◽  
Age Group ◽  
Case Presentation ◽  
Granulation Process ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Active Patient ◽  
Excellent Coverage

Split-thickness skin grafting of the foot following a burn injury provides excellent coverage to promote early rehabilitation and to facilitate healing. When compared to a more slowly healing, cosmetically unacceptable secondary granulation process, grafting is especially important for the young, active patient for whom hospitalization and immobilization are difficult to maintain. Cosmetic results are also a great concern, especially in the female sector of this age group. The case presentation shows grafting as a successful means of treatment in consideration of these primary goals.

831 Optimal Timing for Range of Motion to Upper Extremities Following Split Thickness Skin Autographing: A Five Year Retrospective Review

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S253-S254
Author(s):  
Greta M Rucks ◽  
Rachel B Gonzalez ◽  
Susan L Smith ◽  
Howard G Smith
Keyword(s):  
Range Of Motion ◽  
Upper Extremity ◽  
Hospital Discharge ◽  
Burn Injury ◽  
Skin Grafting ◽  
Functional Independence ◽  
Home Health ◽  
Optimal Timing ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Abstract Introduction The hand and upper extremity is one of the most common sites for burn injury. The total body surface area (TBSA) of the hand is small but the resultant impairment can limit a patient’s ability to return to functional independence. Split thickness skin grafting (STSG) has long been supported in the literature as the main means of treatment following full thickness burn injury. Surgical placement of STSG is often followed by a period of immobilization to the grafted area for graft adherence. The length of time which the grafted area is immobilized has evolved over time as surgical methods have improved. There is no set standard to balance the length of time necessary to prevent complications while maintaining functional mobility. A literature review revealed several studies and a meta-analysis examining the optimal timing for immobilization and bedrest following STSG to the lower extremities. Additional studies have examined guidelines for range of motion protocols and splinting as well as reconstructive procedures for improved function following burn injury. There are currently no studies examining the optimal timing for immobility following the placement of STSG and the implications this can have on functional independence. The proposed study details the results of one burn center’s standard of treatment following STSG to the upper extremity. Methods Following obtaining approval from the IRB, deidentified data was retrospectively collected from the electronic medical record from January 1, 2014-January 1, 2019 for all inpatients ages 18 and up who underwent split thickness skin grafting to the upper extremity. Results Data collected from 2014–2018 revealed a decreasing trend in the days of immobilization following STSG from an average of 4 days to 2 days to the resumption of range of motion (ROM). Additional trends include a decrease in the utilization of splinting as a prophylactic treatment for contractures with a shift towards interventional splinting. Access to home health care services upon hospital discharge also showed a decline from 2014–2018. Conclusions The decrease in days of immobilization following STSG combined with the shift from prophylactic to interventional splinting put more emphasis on increasing patient autonomy for functional independence. This trend coincides with a significant decrease in the utilization of home health services upon hospital discharge in the same time period. Applicability of Research to Practice The findings of this retrospective study provide evidence supporting that decreasing the length of immobilization following STSG to 2 days did not result in an increase in post-operative complications. There was also not a significant decrease in functional independence found with a change in splinting practices from prophylactic to interventional.

scholarly journals Tumescent versus non-tumescent technique in skin graft healing: a cross-sectional study

2018 ◽  
Vol 5 (5) ◽  
pp. 1822
Author(s):  
Ramesh Koujalagi ◽  
V. M. Uppin ◽  
Rajesh Pawar ◽  
Vaibhav Avinash Patil
Keyword(s):  
Blood Loss ◽  
Skin Graft ◽  
Healing Rate ◽  
Donor Site ◽  
Skin Grafting ◽  
Tumescent Technique ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Group A ◽  
Group B

Background: Skin grafting, especially burn surgery, is associated with great blood loss. Tumescent technique is the subdermal injection of fluid containing a vasoconstrictor prior to burn wound surgery to reduce blood loss. Adrenaline is used to harvest skin grafts due to its vasoconstriction effect which limits blood loss. Although adrenaline is widely used, its local and systemic effects vary from patient to patient. The object of the present study was to observe the efficacy of tumescent technique, using adrenaline, versus non-tumescent technique in the healing of split thickness skin graft donor day 10.Methods: Two treatment groups of patients, tumescent (group A, n = 45) and non-tumescent technique (group B, n = 45), who fulfilled the inclusion criteria were randomly assigned. Tumescent technique involved administration of 1 mg (1:1000) adrenaline in 500 mL of saline. No prior administration of agent was performed in non-tumescent technique. Split-thickness skin grafting was carried out followed by regular inspection of the donor site. Healing rate was recorded at the postoperative day 10 by performing wound tracing technique and evaluated by performing unpaired t-test. P <0.05 was considered as statistically significant. Results: The mean age of patients was 29.98±12.6 years in group A and 45.36±10.23 years in group B. Age distribution was concentrated between 18 and 38 years. On postoperative day 10, complete epithelialization was observed in 15.56 % and 6.66% of patients in group A and B, respectively. Compared to the patients in group B, patients who underwent tumescent technique (group A) had higher healing rate (>80%, p=0.0134). Evidence of infection in the donor site was absent in both the groups.Conclusions: Tumescent technique by using adrenaline is more effective than non-tumescent technique in the healing of donor site and can be implemented preoperatively in split-thickness skin grafting.

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.

Outcomes of Split Thickness Skin Grafting on Lower Extremity Wounds in Diabetics

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 111-OR
Author(s):  
ELLIOT WALTERS ◽  
GREG STIMAC ◽  
NEHA RAJPAL ◽  
IRAM NAZ ◽  
TAMMER ELMARSAFI ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Skin Grafting ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting
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