scholarly journals Management and outcome in patients with post burn contracture

2018 ◽  
Vol 6 (1) ◽  
pp. 42 ◽  
Author(s):  
Manu Rajan ◽  
Arnav Tyagi ◽  
Sanjay Dvivedi ◽  
Kinnari A. V. Rawat
Keyword(s):  
Skin Grafting ◽  
Developed Countries ◽  
Medical Sciences ◽  
Reconstructive Procedures ◽  
Burn Care ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Contracture Release ◽  
Flap Cover ◽  
Burn Contractures

Background: Post burn contractures are distressingly common and severe in developing nations and considered as a significant problem in developed countries as well. Despite advances in the overall management of burn injuries, severe post-burn contractures continue to be a formidable foe for reconstructive surgeons in developing countries.Methods: The study was carried out in Department of Surgery, Himalayan Institute of Medical Sciences, SRH University, Swami Ram Nagar, Dehradun over a period of 12months. Cases of the post burn contractures attended in the O.P.D were included in the study.Results: Contracture release with split thickness skin grafting STSG in 25 (55.5%) cases. Contracture release with STSG with flap cover was performed in 7 cases (15.5%), contracture release with K wire insertion with coverage was performed in 8 cases (17.7%) and Z plasty was performed in 5 cases (11%).Conclusions: There have been major advances in burn care in the last three decades and the mortality rates have gone down significantly. The management has shifted to improvement of functional outcome and better quality of life. Proper planning of reconstructive procedures, rehabilitation, restoration to pre-injury status and return to society are the goals that the treating team hopes to achieve.

MANAGEMENT OF POST BURN CONTRACTURE OF NECK IN A TERTIARY BURN CARE CENTRE

2021 ◽  
pp. 33-35
Author(s):  
Nangineedi Nagaprasad ◽  
Karthik G B
Keyword(s):  
Surgical Planning ◽  
Skin Grafting ◽  
Burn Care ◽  
Split Skin Grafting ◽  
Contracture Release ◽  
Common Problems ◽  
A Prospective Study ◽  
Split Skin ◽  
Burn Contractures

Background: Post burn contracture is one of the most common problems in our country and usually seen in lower socio-economic people. Burn contractures of the neck can produce a signicant impact on quality of life by reducing a patient's ability to perform activities of daily living Methods: A prospective study was conducted with a sample size of 30 patients with post burn neck contracture conducted for a duration of 24 months. After meticulous surgical planning, patients underwent contracture release and split skin grafting/z-plasty followed by rigorous splintage and physiotherapy. Majority of the patients were in the age group of 11-30 years (63%).70% of the Results: patients sustained burns in the range of 21-40% and 80% were due to ame burns.46.66% (14) of patients had severe contracture while 13.33% (4) had extensive mento-sternal adhesions. 90% of the patients underwent release + SSG while 10% underwent z-plasty. Postoperatively cervico-mental angle of 100-120 degrees was achieved Skin grafting is a simple, reliable and safe operation however postoperative splinting is n Conclusion: ecessary. The use of skin grafts continues to deliver excellent results with adequate restoration of cervico-mental angle.

scholarly journals Neonatal compartment syndrome

2016 ◽  
Vol 98 (7) ◽  
pp. e111-e113 ◽  
Author(s):  
B Martin ◽  
L Treharne
Keyword(s):  
Compartment Syndrome ◽  
Skin Grafting ◽  
Dermal Matrix ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Left Hand ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Contracture Release

A term neonate was born with a grossly swollen and discoloured left hand and forearm. He was transferred from the local hospital to the plastic surgical unit, where a diagnosis of compartment syndrome was made and he underwent emergency forearm fasciotomies at six hours of age. Following serial debridements of necrotic tissue, he underwent split-thickness skin grafting of the resultant defects of his forearm, hand and digits. At the clinic follow-up appointment two months after the procedure, he was found to have developed severe flexion contractures despite regular outpatient hand therapy and splintage. He has had further reconstruction with contracture release, use of artificial dermal matrix, and K-wire fixation of the thumb and wrist. Despite this, the long term outcome is likely to be an arm with poor function. The key learning point from this case is that despite prompt transfer, diagnosis and appropriate surgical management, the outcome for neonatal compartment syndrome may still be poor.

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

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.

Uncommon Responses of Segmental Vitiligo to Melanocyte-Keratinocyte Transplantation Procedure

2015 ◽  
Vol 19 (2) ◽  
pp. 177-181 ◽  
Author(s):  
Prescilia Isedeh ◽  
Ahmed Al Issa ◽  
Henry W. Lim ◽  
Smita S. Mulekar ◽  
Sanjeev V. Mulekar
Keyword(s):  
Observational Study ◽  
Skin Grafting ◽  
Retrospective Observational Study ◽  
Recipient Site ◽  
Treated Area ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Background Patients with segmental vitiligo (SV), unlike those with nonsegmental vitiligo (NSV), have a more predictable course and are more responsive to surgery. Objective To report 10 patients with SV treated with the melanocyte-keratinocyte transplantation procedure (MKTP), who responded with unusual responses not previously reported in the literature. Methods This is a retrospective, observational study that reports 10 patients with SV who underwent the MKTP between May 2003 and May 2012. Results Two patients had successful repigmentation after split-thickness skin grafting after failure of the MKTP. Two patients developed a hypopigmented ring at a margin of the MKTP-treated area. One patient had complete repigmentation after a second MKTP. Two patients developed koebnerization of the recipient site. Three patients developed new vitiligo patches in previously unaffected areas after the MKTP. Conclusions Uncommon and even suboptimal responses can occur following the MKTP in SV patients. There is a need for studies to provide better understanding and outcomes for SV patients undergoing the MKTP.

EKSISI DAN MEGA PROSTHESIS PADA GIANT CELL TUMOR PROXIMAL TIBIA (LAPORAN KASUS)

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Mujaddid Idulhaq ◽  
Bayu Sakti Jiwandono ◽  
Ariya Maulana Nasution ◽  
Handry TH
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Limb Salvage ◽  
Proximal Tibia ◽  
Skin Grafting ◽  
Cell Tumor ◽  
Limb Salvage Surgery ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Muscular Flap

Giant cell tumor (GCT) merupakan tumor destruktif tulang yang muncul di antara dekade kedua dan keempat, lokasi predileksi umumnya pada epifisis tulang panjang. Pemilihan tatalaksana operasi sangat penting dan masih menjadi perdebatan. Sebagaimana masih beragamnya pilihan tindakan pembedahan. Klasifikasi Campanacci dapat digunakan sebagai acuan untuk panduan tatalaksana. Pada kasus ini kami melaporkan seorang wanita, usia 18 tahun dengan diagnosa giant cell tumor pada proximal tibia dextra dengan Campanacci grade III. Pasien telah menjalani operasi limb salvage tahap pertama berupa eksisi luas pada proximal tibia dextra dan knee arthrodesis. Setelah 4 bulan dilakukan operasi limb salvage tahap kedua yaitu knee arthroplasty dengan megaprosthesis. Untuk mencegah komplikasi implant expose, dilakukan muscular flap dan split thickness skin grafting (STSG). Setelah dilakukan evaluasi selama 4 bulan, klinis pasien baik, pasien dapat berjalan alat bantu dan tanpa nyeri, tidak ada komplikasi pada luka operasi dan fiksasi implan baik. Kesimpulan yang didapatkan bahwa limb salvage surgery pada giant cell tumor proximal tibia dapat dilakukan dengan tindakan rekonstruksi dua tahap. Teknik muscular flap dan split thickness skin grafting (STSG) dapat digunakan untuk mencegah terjadinya implant expose.

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