Algorithm for Primary Full-thickness Skin Grafting in Pediatric Hand Burns
Background Pediatric hand burns are a difficult problem because they lead to serious hand deformities with functional impairment due to rapid growth during childhood. Therefore, adequate management is required beginning in the acute stage. Our study aims to establish surgical guidelines for a primar...
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Published in | Archives of plastic surgery Vol. 39; no. 5; pp. 483 - 488 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
Thieme Medical Publishers, Inc
01.09.2012
The Korean Society of Plastic and Reconstructive Surgeons 대한성형외과학회 |
Subjects | |
Online Access | Get full text |
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Summary: | Background
Pediatric hand burns are a difficult problem because they lead to serious hand deformities with functional impairment due to rapid growth during childhood. Therefore, adequate management is required beginning in the acute stage. Our study aims to establish surgical guidelines for a primary full-thickness skin graft (FTSG) in pediatric hand burns, based on long-term observation periods and existing studies.
Methods
From January 2000 to May 2011, 210 patients underwent primary FTSG. We retrospectively studied the clinical course and treatment outcomes based on the patients' medical records. The patients' demographics, age, sex, injury site of the fingers, presence of web space involvement, the incidence of postoperative late deformities, and the duration of revision were critically analyzed.
Results
The mean age of the patients was 24.4 months (range, 8 to 94 months), consisting of 141 males and 69 females. The overall observation period was 6.9 years (range, 1 to 11 years) on average. At the time of the burn, 56 cases were to a single finger, 73 to two fingers, 45 to three fingers, and 22 to more than three. Among these cases, 70 were burns that included a web space (33.3%). During the observation, 25 cases underwent corrective operations with an average period of 40.6 months.
Conclusions
In the volar area, primary full-thickness skin grafting can be a good indication for an isolated injured finger, excluding the web spaces, and injuries of less than three fingers including the web spaces. Also, in the dorsal area, full-thickness skin grafting can be a good indication. However, if the donor site is insufficient and the wound is large, split-thickness skin grafting can be considered. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 G704-000758.2012.39.5.023 |
ISSN: | 2234-6163 2234-6171 |
DOI: | 10.5999/aps.2012.39.5.483 |