Skin Grafting Compared with Conservative Treatment in Patients with Deep Second-Degree Burn Wounds of the Trunk and Buttocks

Abstract

BACKGROUND Burns are among the most common causes of injury and result in long-term morbidity, psychological complications, and reduced quality of life. We aimed to evaluate and compare the results of skin grafting versus nonsurgical treatment in patients with deep second-degree burn wounds of the back and posterior trunk. METHODS This is a descriptive-analytical cross-sectional study of patients with trunk and buttock burns admitted to Burn Hospital in Shiraz, Iran from 2017 to 2019. The skin surface with burns and the final repaired tissue was measured. The Vancouver Scar Score (VSS) and pigmentation, vascularity, thickness, and pliability were assessed. VSS, pigmentation, vascularity, thickness and pliability were considered as outcomes. RESULTS Seventy-five patients met the criteria for participation; thirty-two patients had skin grafts. The mean age was 27.79±20.03 yr and 53 patients (70.7%) were male. Scars were compared based on pigmentation, vascularity, thickness, and pliability, which was also statistically significant ( P <0.001). The mean of VSS was higher in patients with skin graft than those without graft ( P <0.001). CONCLUSION The mean VSS was significantly higher in patients with grade 2 deep burns who received skin grafting than in patients without skin grafting. Due to the lack of donor sites and the need to prioritize skin grafts in burn patients with high total body surface area, it is better to perform skin grafts on the posterior trunk and buttocks in areas with deep grade 2 burns as a last priority and treat this wound with conservative therapy.

Successful treatment for a 90-year-old female with severe perineal and buttock burns and concomitant COVID-19 pneumonia: A case report and literature review

“…With age, senescent cells accumulate in the skin and spread the aging phenotype to neighboring cells, resulting in decreased thickness, regenerative capacity, and a barrier effect in the skin [11,12]. In most cases, the wound of the elderly is deeper than that of the young after scald.…”

Outcomes of Muscle versus Fasciocutaneous Free Flap Reconstruction in Acute Burns: A Systematic Review and Meta-analysis

“…1 Full-thickness burns demand prompt excision and coverage for improved patient outcomes, often utilizing skin grafting as a prevalent reconstructive technique in burn surgery. 2 In cases involving extensive defects and exposure of critical structures such as bone, tendons, or neurovascular tissues, a robust and durable reconstruction through well-vascularized and healthy tissue transfer becomes the optimal choice. 3 Although soft tissue defects resulting from a burn injury can be managed with local flaps, their application is sometimes limited by the wound size of involvement of local tissues in the zone of injury.…”