Burns : journal of the International Society for Burn Injuries
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The authors present two patients affected by scars resulting from burning of over 60 per cent of the total body area, in which the pre-expansion of a free flap has been used to increase the tissue surface useful for transfer from the only area of residual healthy skin (left forearm, left parascapular region). In both cases it was possible to transfer abundant healthy tissue into the desired areas, obtaining a rapid release of the region, which made possible an early physical rehabilitation of the patient starting after the second postoperative week. ⋯ The pre-expansion of free flaps provides an advantage in that it allows the few integral residual areas to be used, improving vascularization and therefore increasing the available surface. Furthermore, as pre-expansion reduces tension on the margins, it allows for the easier closing of the donor area, with a minor risk of complications and a better scar outcome.
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Electrocution due to contact of construction equipment with power lines is not uncommon as a source of industrial injury. We report seven such cases. Two patients sustained cardiac arrest and were successfully resuscitated at the scene. ⋯ In all cases, the patient was on the ground touching the machinery or touching cables connected to the machinery at the time of injury. The importance of exercising due care in industrial safety measures is stressed. Prompt CPR was life saving in two cases.
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Comparative Study Clinical Trial
Micrografting in the treatment of severely burned patients.
The micrografting technique, employed to treat patients with extensive TBSA burns and reduced areas of healthy donor skin, was assessed simultaneously with traditional mesh grafts (STSG) or Tiersch grafts in the treatment five severely burned subjects (average TBSA burned 35.6 per cent; average per cent of full thickness wounds 32.6 per cent). At the first clinical control on day 6 post-surgery, 93 per cent of the micrografted area was in situ and health; epithelialization of the wound sites was complete at day 21. ⋯ Although the micrograft technique is labour-intensive, if the expansion needed is at least 1:6, the aesthetic and functional results obtained are comparable to, or better than, those with meshed grafts. Also, large segments of micrograft are not compromised if a small area of mesh becomes detached, and epithelialization is faster and more uniform, enabling a reduction in both infection and length of hospital stay.
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An unusual cause of burn, contact with boiling wax by children and adolescents during the annual mid-autumn festival in Hong Kong is presented. 57 patients who suffered from hot wax burn over the period 1986-1996 were admitted to the Burns Unit of the Prince of Wales Hospital. This special burn should be preventable by public education.
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The development of aberrant pigmentation represents an unwelcome complication to an otherwise successful split skin graft resulting in a loss of colour match and, so it follows, of cosmesis. We present two cases where lasers have been successful in the treatment of this problem.