scholarly journals Management of post burn contracture of neck

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Muhammad Afzal ◽  
Javaid Iqbal ◽  
Muhammad Sajid ◽  
Muhammad Rehman Gulzar ◽  
Mustehsan Bashir
Keyword(s):  
Skin Graft ◽  
Simple Procedure ◽  
Skin Grafting ◽  
Local Flap ◽  
Musculocutaneous Flap ◽  
Teaching Hospitals ◽  
General Surgeon ◽  
Split Skin Graft ◽  
Split Skin Grafting ◽  
Split Skin

Study Design: It is a prospective analytical study. Place and durations: Subjects & methods: 43 patients admitted during JAN 2001 to DEC 2002 who presented with severe functional (25 patients) of cosmetic impairment (27 patients). We selected 4 different options to manage the patients. (1) Release of/or excision + thigh grafts (2) Release of/or excision + wolfm (3)Thick therish + local flap (4) Musculocutaneous flap. Results: Out of 43 patients 27 were females and 16 were male and the age varies from 4-45 years. Out of 28 patients a (1) 25 given satisfactory and excellent results, and 5 out of Six patients a (2) and 4 out of 5 with (3) gave excellent results. To evaluate the outcome of different options for the management of PBNC we are presenting our 2 years experience of PBNC Neck in 43 patients from January 2001 to December 2002 who were admitted through surgical outdoor of Teaching Hospitals of PMC, Faisalabad. In our set up most of the patients presented with severe functional (25 patients) and cosmetic impairments (27 patients out of 43) because of late presentation, delayed treatment, poverty and lack of proper medical facilities. We selected 4 different options to manage these patients accordingly i.e. (1) release or and excision of contracture and thick split skin graft, (2) release or and excision of contracture and full thickness skin graft, (3) thick split skin graft and local flap, (4) musculocutaneous flap, giving satisfactory to excellent results in 25 out of 28 patients, 5 out of 6 patients and 4 out of 5 patients respectively. Thick split skin grafting after release or/and excision of contracture with strict advice of wearing cervical neck collar remained our mainstay of treatment because it was one of the best practical options to deal with severe PBC Neck while other options being reserved for difficult and recurrent cases. Conclusion: Thick split skin grafting is an easy, cost effective, reliable and compliant to the patient. Furthermore thick split skin grafting is a simple procedure whi ch may be carried out by any general surgeon with reserve for referred for the difficult cases.

scholarly journals Regrafting of the Split-Thickness Skin Graft Donor-Site: Is It Beneficial?

2019 ◽  
Author(s):  
Catherine M Legemate ◽  
Ymke Lucas ◽  
Irma M M H Oen ◽  
Cornelis H Van Der Vlies
Keyword(s):  
Skin Graft ◽  
Donor Site ◽  
Skin Grafting ◽  
Split Thickness Skin Graft ◽  
Split Skin Graft ◽  
Thickness Skin ◽  
Split Skin Grafting ◽  
Split Thickness Skin Grafting ◽  
Graft Donor ◽  
Split Skin

Abstract Split-thickness skin grafting remains a fundamental treatment for patients with deep burns and other traumatic injuries. Unfortunately, the donor site wound that remains after split skin graft (SSG) harvesting may also cause problems for the patient; they can lead to discomfort and scars with a poor cosmetic outcome. Regrafting of the donor site is one of the methods described to improve donor site healing and scarring. In this report, we describe a case of a 26-year-old woman with a self-inflicted chemical burn (0.5% TBSA) who underwent split skin grafting. During surgery, only part of the donor site was regrafted with split skin graft remnants. This part healed faster and had a better scar quality at 3 months postsurgery. Nevertheless, the appearance and patients’ opinion on the regrafted part deteriorated after 12 months. With this case report, we aim to create awareness of the long-term consequences of regrafting, which may differ from short-time results. Patients expected to have poor reepithelialization potential may benefit from regrafting of the SSG on the donor site. But in healthy young individuals, timewise there would be no benefit since it can lead to an aesthetically displeasing result.

scholarly journals EMLA- AN EFFECTIVE TOOL FOR TOPICAL ANALGESIA IN SPLIT SKIN GRAFT HARVEST

2020 ◽  
pp. 1-4
Author(s):  
Lalit Agrawal ◽  
Fahud Khurram ◽  
Naveen Khubchandani
Keyword(s):  
Visual Analogue Scale ◽  
Skin Graft ◽  
Analogue Scale ◽  
Skin Grafting ◽  
Split Skin Graft ◽  
Emla Cream ◽  
Graft Harvest ◽  
Group 2 ◽  
Split Skin ◽  
Group 1

Background: Many patients require general anesthesia merely for skin grafting. EMLA cream which is aeutectic mixture of Lignocaine and Prilocaine provides surface anesthesia when applied on intact skin. Its role in venepuncture or IV cannula insertion in children is well documented. Aim and Objective: To compare effectiveness of EMLA over inltrative local anaesthesia in split skin graft harvest. Method: A prospective study was conducted on 64 patients who required skin grafting. Various indications for grafting were noted. The patients were randomly allocated to two groups. In one group 32 patients, graft was harvested after application of EMLA cream whereas in another group of 32 patients, graft was harvested by inltrating local anesthesia. Pain perceived during donor area preparation, graft harvesting and post-operative pain was recorded and compared between the two groups on Visual analogue scale and Likert scale. Results: Total 64 patients were included in the study with 32 patients in either group. Traumatic loss of skin was the most common indication in either group for skin graft harvest. As per visual analogue scale during the graft harvest, most of the patients were in the range of 4-7 score in either group (71.87% vs 53.12%). 75% of the patients were in the 4-7 score in both groups. As per likert scale during the graft harvest score of 4 was noted in 62.5% in group 1 vs 53.12% in group 2 patients. 81.25% patients in group 1 reported procedure as excellent versus 53.12% patients in group 2. Patients experienced more pain during inltration of local anesthesia. Whereas more bleeding was noted in EMLA group immediately after harvest of graft. Conclusions: EMLA cream can be effectively used as an alternative to local anaesthetic inltration for harvest of split thickness skin graft

The Split Skin Graft Donor Site: Can Pretreatment with Vitamin a Cream Help?

2002 ◽  
Vol 10 (2) ◽  
pp. 78-80
Author(s):  
Pj Skoll ◽  
M Soldin ◽  
M Grob ◽  
B Seymour ◽  
J Davies ◽  
...  
Keyword(s):  
Vitamin A ◽  
Skin Graft ◽  
Donor Site ◽  
Skin Grafting ◽  
Hot Water ◽  
Split Skin Graft ◽  
Clinical Criteria ◽  
Split Thickness Skin Grafting ◽  
Graft Donor ◽  
Split Skin

Background A skin graft donor site that heals rapidly with less cosmetic sequelae is of particular benefit to children with burns. Vitamin A cream has been shown to speed up healing after controlled ‘burns’ (dermabrasion and CO2 laser) if it is applied six weeks before treatment. Objective To assess whether pretreatment with vitamin A cream increases the rate of healing of split skin graft donor sites in children with burns. Methods Prospective study of children with hot water burns of 8% to 30% that required split thickness skin grafting. Vitamin A cream was applied bidaily to one thigh and/or buttock of each child for five to seven days before skin grafting. At surgery, equal thickness grafts were harvested from both thighs and/or buttocks. Biopsies were taken from each thigh and/or buttock and were sent for histological analysis. The rate of donor site healing was monitored clinically and with serial photographs. Results No difference in the rate of healing was noted between the treated and untreated sides by either histological or clinical criteria. Conclusions Vitamin A cream applied bidaily for a period of five to seven days did not affect the healing rate of the split skin graft donor sites in children with burns.

scholarly journals Dosed tissue stretching in the preparation of the donor site for chronic wounds split-skin grafting

2019 ◽  
Vol 6 (1) ◽  
pp. 25-33 ◽  
Author(s):  
I. V. Pavlenko ◽  
V. V. Beschastnov ◽  
M. G. Ryabkov
Keyword(s):  
Skin Graft ◽  
Traditional Method ◽  
Donor Site ◽  
Skin Grafting ◽  
Main Group ◽  
Male Rats ◽  
Control Group ◽  
Results Of Treatment ◽  
Split Skin Grafting ◽  
Split Skin

Objective. Development of a new method for preparing an skin graft to hypoxia conditions in a recipient wound by tissue stretching of the donor site.Materials and methods. Scientific hypothesis: dosed tissue stretching and localized circulatory compensated hypoxia resulting in this increase the concentration of cytokine HIF-1α in the area of distracted skin graft. The experiment was performed on 18 white outbred male rats. The level of local circulatory compensated hypoxia was monitored by using laser Doppler flowmetry. An enzyme immunoassay was used to determine the concentration of cytokine HIF-1α in tissue. In the clinical stage of the study, the results of treatment in 9 patients – main group (split-skin grafting developed by the original method) were compared with the results of treatment in 10 patients – control group, who underwent plastic closure according to the traditional method.Results.The experiment revealed a statistically significant difference between the concentration of cytokine HIF-1α in the intact and disractablegraft, which was confirmed by the results of a clinical study.In the group where split-skin grafting was performed according to the traditional method (control group), the graft engraftment area was (Me [Q1; Q3]) 71.0 [65; 78] %, in the main group – (Me [Q1; Q3]) 87.0 [79; 95] % (p = 0.0003).Conclusion. It is advisable to use a compensated reduction of microcirculation in a tissue subjected to dosed tissue stretching to train split-skin graft for hypoxia conditions.

scholarly journals 500 Tetraminos Flap

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Schrire ◽  
A Din ◽  
U Khan
Keyword(s):  
Skin Graft ◽  
Free Flap ◽  
Femoral Condyle ◽  
Computer Game ◽  
Skin Grafting ◽  
Free Flaps ◽  
Soft Tissue Defect ◽  
Split Skin Grafting ◽  
The Right ◽  
Split Skin

Abstract 30 year old male, who had been hit at 90mph whilst on a motorbike sustaining femoral, tibial and right foot open fractures. He underwent an open reduction and internal fixation (ORIF) of his right lateral femoral condyle, a right retrograde femoral nail, and ORIF of the tibia. He had 2 separate free flaps (a chimera scapular/parascapular and antero-lateral thigh-ALT) to his right lower leg, and split skin grafting to the remainder of the right lower limb. Upon regular post-operative review it was found that whilst healed the limb was showing a poor return of function and a major contributor was the lack of motion of the right knee joint. Patient had an excision of the split skin graft, with a quadriceps plasty, where the myofascial planes were released, and the contractures incised, with a chimeric scapular and parascapular free flap onto the defect. This resulted in coverage of large soft tissue defect with no need to skin graft donor sites and no functional implication of muscle harvest. Tetraminos in appearance, like the popular computer game, which has never before been described, compared with normal coverage, which would be latissimus dorsi free flap and graft.

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