Early excision and grafting versus delayed grafting in deep burns of the hand

Badr, Mohammed L; Keshk, Tarek F; Alkhateeb, Yahia Mohammed; Refaai, Ashraf Moustafa Esmail El

doi:10.18203/2349-2902.isj20194404

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…Однією з таких методик є раннє тангенціальне висічення нежиттєздатних тканин з одночасною аутодерматопластикою [1,6,7]. Проте слід зазначити, що ця методика є технічно складною та може становити додатковий стрес для пацієнта зі значними опікови-ми ранами.…”

Section: оригінальні дослідження комбустіологіяunclassified

Advantages of tangential excision with simultaneous autodermoplasty for treating burn wounds

Farmaha,

Lukavetskyi,

Chemerys

2023

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Burn trauma remains an important health problem, among which thermal burns of the limbs are one of the most common and complex due to the need to restore limb function and reduce aesthetic defects. Early tangential excision with simultaneous autodermoplasty is a complex technique that is also a significant stress for the patient, but it allows achieving all the set goals. Purpose - to evaluate the effectiveness of tangential excision with simultaneous autodermoplasty for treating burn wounds compared to the classical method of treatment. Materials and methods. The study included 24 patients with burns of the upper and/or lower limbs, from which two groups were formed: an experimental group (12 patients) and a control group (12 patients) who were equal in terms of patient sex, age, etiology of burn wounds, affected area. Tangential excision with simultaneous autodermoplasty was applied to patients in the experimental group, while delayed sequential necrectomy, xenoplasty (if necessary), and delayed autodermoplasty were performed on patients in the control group. Results. Patients in the experimental group stayed in the hospital for an average of 10.5±4.5 days, which was almost half as long as in the control group (20.2±3.5 days). The number of surgical interventions in the experimental group was 1.3±0.5 operations, while in the control group it was 2.7±0.8 operations, and the number of general anesthesia procedures in the experimental group was significantly lower (1.3±0.5) than in the control group (4.6±1.1; p<0.05). In the experimental group, the number of dressings for each injury was 4.3±1.6, while in the control group it was almost three times as many (12.7±3.0; p<0.05). The duration of healing of burn wounds in the experimental group was 13.3±4.3 days, which was shorter than in the control group (24.2±3.9 days; p<0.05). The prevalence rate of infectious complications in the experimental group was 21.1% (4 cases), while in the control group it was significantly higher (58.8%). However, the prevalence rate of other complications, such as lysis of skin grafts, was only slightly lower in the experimental group (15.8%, or 3 cases) compared to the control group (29.4%, or 5 cases). 2 (18.2%) burn wounds in the experimental group required secondary reconstruction, while in the control group, 7 (70.0%) wounds required it. Conclusions. Treatment of burn wounds of the upper and/or lower limbs using the method of tangential excision with simultaneous autodermoplasty allows for a reduction in the length of hospital stay, a decrease in the number of surgical interventions, general anesthesia procedures, dressing changes, and ensures faster wound healing, as well as reduces the frequency of complications and the need for secondary reconstruction. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

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Section: оригінальні дослідження комбустіологіяunclassified

Advantages of tangential excision with simultaneous autodermoplasty for treating burn wounds

Farmaha,

Lukavetskyi,

Chemerys

2023

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Challenges in surgery of deep burns

Certic,

Dimkic-Milenkovic,

Jovanovic

2023

Srp Arh Celok Lek

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Introduction. Full thickness burns pose a significant challenge in terms of surgical management, particularly when concurrent trauma of other organs is involved. Traditional treatment of deep burns includes early excision or debridement of necrotic tissue, followed by skin grafting or flap reconstruction. There are numerous challenges such as poor overall general condition, polytrauma, questionable wound bed viability, limited donor sites. Thus, we have to consider skin substitutes. INTEGRAR is a acellular dermal substitute which create a native dermis. The aim of this case was to share our experience of the treatment by skin substitutes in the polytraumatized burn patient. Case outline. We present the case report of a 46-year-old man with the severe work-related contact burn wounds associated with multiple rib and vertebral fractures as well as lungs contusion with localized bilateral hemothorax. Patient suffered from third-degree burns to the lower extremities, extending to scrotal and gluteal area, which included 15% of total body surface area. Patient underwent early excision of necrotic tissues with subsequently skin autografting on right leg, however, due to partial failure of autografts we had to perform allografting followed by autografting because of limited local donor sites and poor general condition. Successive debridement and partial osteotomy resulted in left knee defect with exposed patella. Therefore, in order to reconstruct consequent defect and prevention of joint contracture, defect was finally covered by INTEGRAR. Conclusion. Our experience has highlighted that INTEGRAR prevents functional disability and furthermore, it leads to optimal aesthetic results.

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Early Tangential Excision and Split-Thickness Skin Graft Reduced Hospitalized Length Stays for Burn Injuries

Kusuma,

Saputro,

Handriani

et al. 2024

Biomolecular and Health Science Journal

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Introduction: Burns pose a physical, psychological, health system, and long-term length of stay problem. Surgical treatment of burns is an important intervention in their management. The optimal timing of early tangential excision and split-thickness skin graft varies. Early excision of burned tissue to remove dead tissue and inhibit the inflammatory process decreases the risk of infection. Early excision and grafting of burns is the standard of practice for most major burns. Methods: The research was a cross-sectional study with a descriptive design of secondary data. Burn patients were treated at Dr. Soetomo General Academic Hospital Surabaya, Indonesia, from 2018 to 2022. Inclusion criteria in this study were all patients who underwent early tangential excision and split-thickness skin graft. Achieving statistical analysis and data analysis using SPSS 25 on Windows. Results: A greater amount of time on total body surface area (TBSA) is linked to early tangential excision and split-thickness skin grafts. There are statistically significant variations in the burn area (TBSA 20.5%–30%, P = 0.036 (P = 0.05), TBSA 30.5%–40%, P < 0.001, and burn area (TBSA 40.5%–50%, P = 0.003). The current findings demonstrated that split-thickness skin grafts and early tangential excisions done on burns with TBSA 20% at partial thickness–full thickness depth had statistically significant outcomes, shortening the length of stay for burn patients. Conclusions: An analysis of the current data, burn patients’ duration of stay was reduced when burns with TBSA >20% with partial thickness–full thickness depth underwent early tangential excision and split–thickness skin transplant had statistically positive results.

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Early excision and grafting versus delayed grafting in deep burns of the hand

Cited by 3 publications

References 7 publications

Advantages of tangential excision with simultaneous autodermoplasty for treating burn wounds

Advantages of tangential excision with simultaneous autodermoplasty for treating burn wounds

Challenges in surgery of deep burns

Early Tangential Excision and Split-Thickness Skin Graft Reduced Hospitalized Length Stays for Burn Injuries

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