Burns : journal of the International Society for Burn Injuries
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Expanding oral angle plasty using a subcutaneous pedicle flap to correct severe microstomia due to extensive facial scar contractures is described. This technique is especially suited for the elderly, who are unable to tolerate large skin grafting of the face, and for patients with insufficient normal donor skin to undertake extensive correction of scar contractures.
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Comparative Study
Wound contraction following transplantation of microskin autografts with overlaid skin allograft in experimental animals.
The wound contraction associated with a new grafting technique, transplantation of microskin autografts with overlaid skin allograft, was evaluated in a rat model. Male inbred Lewis rats were used as microskin autograft recipients while Buffalo rats were used as allogeneic skin graft donors providing a sheet allograft for overlay. ⋯ The results showed that the application of autologous microskin grafting with allograft overlay was associated with more scar contraction than was the use of a sheet isograft. Maximum contraction to 43 per cent of the original size appeared at 7 weeks postgrafting in the microskin grafting group, while in the sheet isografting group the greatest contraction occurred at 4 weeks postgrafting when it retained 72 per cent of the original size.
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Case Reports
Maintenance of stump length of both upper extremities after severe electrical burn injury.
A patient with electrical injury to both upper extremities which necessitated amputation above the elbow on both sides is presented. Further débridement on the stumps resulted in extensive exposure of bone with little coverage by skin and granulation tissue. Adequate coverage and maintenance of the length of both stumps was possible with bilateral myocutaneous latissimus dorsi flaps. This enabled the patient to carry out various activities and to wear a prosthesis.
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Cultured keratinocytes were used as allografts on burn wounds in two patients. In both patients successful covering of the wounds was obtained. DNA fingerprinting of the epidermis covering the wounds 21 days later showed that the cultured keratinocytes were replaced by the patients' cells.
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Over a 12-month period, 1704 children less than 15 years old with burn injuries seen in the accident and emergency departments of seven major regional hospitals in Hong Kong were analysed with respect to their epidemiological data. The age group with the highest risk for injury was 0-4 years (57 per cent) and with a maximum at 1-2 years of age. Boys showed a significantly higher incidence of burns than girls at any age. ⋯ In the great majority of patients the total body area of burn did not exceed 5 per cent. Younger children had a higher incidence of burns involving the head, face and anterior trunk, 39 per cent of the 0-4 year age group required hospital admission. During the winter months, the children tended to suffer from deeper burns.