SUMMARY -Th e purpose of this study was to create a fi brin-based human skin substitute in vitro with epidermal and dermal component and to assess its healing potential in deep partial and full thickness burns. Fibrin scaff olds were prepared from commercial fi brin glue kits. Human fi broblasts were cultured in fi brin gel. Human keratinocytes were seeded on the top of the gel. Viability of cells was determined fl uorimetrically. Scanning electron microscope and immunocytochemistry analysis of cultured cells were performed. After hydrosurgical preparation of deep burn necrotic tissue, wound bed was prepared for skin substitutes. Progress of healing was documented using visual estimation and photos. Scanning electron microscope images showed good cell attachment and colony spreading of keratinocytes and fi broblasts on fi brin scaff old. Immunofl uorescent staining of cell cultures on fi brin scaff old showed expression of vimentin, a marker of fi broblast cells, cytokeratin 19, a marker of epithelial stem cells, as well as involucrin, a marker of diff erentiated keratinocytes. Clinical results clearly showed that appearance of the skin did not diff er signifi cantly from the areas of transplanted skin using split-thickness skin graft techniques. In conclusion, using these fi brin-cultured autografts on massive full-thickness burn resulted in good healing.

Integra dermal regeneration template has been well established in treating deep extensive burns, but there are very few cases reported of treating large full-thickness skin defects such as giant nevi. Apart from psychological and cosmetic burdens, the giant congenital nevus carries increased risk of malignant alteration. We present the case of a 9-year-old girl with a giant congenital nevus on her left lower leg. A total excision was done and she was successfully treated with Integra (LifeSciences Corp, Plainsboro, NJ). Three weeks later, a thin split-skin graft was applied over the neodermal skin layer. The takeoff was 91%. Protected with the silver wound dressing, the rest of the wound healed. A donor site morbidity was minimal, and the final result was excellent both in aesthetic and functional aspects.

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Introduction Fractures of the phalanges in children can often be underappreciated by the physician of first contact. Therefore it is necessary to point out which of these fractures, because of the risk of possible future complications, need special mention. Materials and Methods A retrospective review of 512 fractures of the phalanges in children and adolescents during an one year period. Fractures were subdivided into the following categories – physeal fractures, intraarticular (phalangeal neck and condylar) fractures, shaft fractures, tuft fractures, “mallet finger” fractures, volar plate avulsion injuries and collateral ligament avulsion injuries. Main outcome measures was the necessity for operation while the average age at which the injury has occured, the cause of the injury, the frequency of injury of each finger, the necessity for reduction, and the duration of splinting were the secondary outcome measures. Results Collateral ligament avulsion injuries and intraarticular (phalangeal neck and condylar) fractures were injuries which most often necessitated operative treatment. Physeal injuries were the most common injuires with avulsions of the volar plate being the second most common. Accidents during sport was by far the most common cause of injuires in all categories apart from tuft injuries. Conclusion The findings regarding the incidence and the cause of these injuries in this study support the already published dana in the literature. The physician of first contact has to be capable to recognise the problematic fractures – intraarticular (phalangeal neck and condylar), significantly displaced Salter-Harris type III and IV fractures and collateral ligament avulsion injuries and Seymour fractures.