Early Treatment of Burns of the Dorsum of the Hand by Tangential Excision and Skin Grafting

Wexler, Menachem R.; Yeschua, Ruth; Neuman, Z

doi:10.1097/00006534-197409000-00003

Cited by 26 publications

(6 citation statements)

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“…We suggest that this was mainly caused by sufficient debridement [ 13 , 24 ]. There are fewer reports about full-thickness debridement for surgery of a deep dermal burn of the dorsum of the hand than there are for tangential excisions [ 1 , 2 , 14 , 15 , 25 – 27 ]. Our treatment strategy in the FTD group is fundamentally in line with a report by Gurfinkel et al [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…To optimize skin graft take, adequate debridement is essential [ 13 ]. With regard to the depth of debridement, partial-thickness debridement (PTD) (i.e., tangential excision, using punctiform hemorrhage as an indicator of the required depth of debridement) is one of the most commonly used procedures for excision of burned tissue of the dorsum of the hand [ 14 ]. In contrast, there have been reports of full-thickness debridement (FTD) performed using a tourniquet while exposing the pearly yellowish-white underlying tissue of the dermis and using it as an indicator of the required depth of debridement [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Hyperpigmentation after surgery for a deep dermal burn of the dorsum of the hand: partial-thickness debridement followed by medium split-thickness skin grafting vs full-thickness debridement followed by thick split-thickness skin grafting

et al. 2016

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BackgroundEarly excision and skin grafting are commonly used to treat deep dermal burns (DDBs) of the dorsum of the hand. Partial-thickness debridement (PTD) is one of the most commonly used procedures for the excision of burned tissue of the dorsum of the hand. In contrast, full-thickness debridement (FTD) has also been reported. However, it is unclear whether PTD or FTD is better.MethodsIn this hospital-based retrospective study, we compared the outcomes of PTD followed by a medium split-thickness skin graft (STSG) with FTD followed by a thick STSG to treat a DDB of the dorsum of the hand in Japanese patients. To evaluate postoperative pigmentation of the skin graft, quantitative analyses were performed using the red, green, and blue (RGB) and the hue, saturation, and brightness (HSB) color spaces. We have organized the manuscript in a manner compliant with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.ResultsData from 11 patients were analyzed. Six hands (five patients) received grafts in the PTD group and eight hands (six patients) received grafts in the FTD group. Graft take was significantly better in the FTD group (median 98 %, interquartile range 95–99) than in the PTD group (median 90 %, interquartile range 85–90) (P < 0.01). Quantitative skin color analyses in both the RGB and HSB color spaces showed that postoperative grafted skin was significantly darker than the adjacent control area in the PTD group, but not in the FTD group.ConclusionsThere is a possibility that FTD followed by a thick STSG is an option that can reduce the risk of hyperpigmentation after surgery for DDB of the dorsum of the hand in Japanese patients. Further investigation is needed to clarify whether the FTD or the thick STSG or both are the factor for the control of hyperpigmentation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hyperpigmentation after surgery for a deep dermal burn of the dorsum of the hand: partial-thickness debridement followed by medium split-thickness skin grafting vs full-thickness debridement followed by thick split-thickness skin grafting

et al. 2016

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“…Lawrence et al studied the same tangential excision technique in detail [2]. Wexler et al [3] and John L. Hunt et al [4] studied the same technique in exposed cosmetic zones such as hands. All the above studies explained the technique of Tangential excision, followed by skin grafting.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study of Skin Resurfacing to Maximise Cosmesis and Function in Full Thickness Second Degree Burns

Tamilselvan¹,

Dhanapal²,

Meera³

2016

IOSR

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“…Our observations show that local discomfort from pruritus and heat sensitivity is greatly relieved and no problems have occurred with several of our patients who live in the Middle East. On reviewing the literature there are several reports of early tangential excision of hand burns following elevation and compression dressing (Barron, 1971 ;Wexler et al, 1974). However, we feel that the further refinements of dressing with porcine skin and delayed primary grafting allow a better take of grafts with all its advantages.…”

Section: Discussionmentioning

confidence: 99%

A method of grafting hand burns following early excision

Davies¹,

Yiacoumettis²

1978

Journal of British Surgery

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Early Treatment of Burns of the Dorsum of the Hand by Tangential Excision and Skin Grafting

Cited by 26 publications

References 0 publications

Hyperpigmentation after surgery for a deep dermal burn of the dorsum of the hand: partial-thickness debridement followed by medium split-thickness skin grafting vs full-thickness debridement followed by thick split-thickness skin grafting

Hyperpigmentation after surgery for a deep dermal burn of the dorsum of the hand: partial-thickness debridement followed by medium split-thickness skin grafting vs full-thickness debridement followed by thick split-thickness skin grafting

A Prospective Study of Skin Resurfacing to Maximise Cosmesis and Function in Full Thickness Second Degree Burns

A method of grafting hand burns following early excision

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