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CC BY-NC 4.0 · Arch Plast Surg 2012; 39(05): 483-488
DOI: 10.5999/aps.2012.39.5.483
Original Article

Algorithm for Primary Full-thickness Skin Grafting in Pediatric Hand Burns

Yang Seo Park
Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
,
Jong Wook Lee
Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
,
Gi Yeun Huh
Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
,
Jang Hyu Koh
Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
,
Dong Kook Seo
Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
,
Jai Koo Choi
Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
,
Young Chul Jang
Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
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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.

Keywords

Burns - Child, preschool - Skin transplantation


Publication History

Received: 08 May 2012

Accepted: 20 July 2012

Article published online:
01 May 2022

© 2012. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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