A. Idicula1, M. Effendi1, A. Nair1, J. Griswold1 1Texas Tech University,Surgery,Lubbock, TX, USA
Introduction: Split Thickness Skin Grafting (STSG) is considered one of the principal techniques in the treatment of hand burns in the setting of larger, more complex burn injuries. While traditional STSG does have a few advantages over 1:1 meshed STSG, such as better cosmesis, less surface scaring, and better long term appearance and function they do have many disadvantages. These disadvantages include a longer operating time, increased time demands for deblebbing , limited donor site availability, and longer post-operative healing times.
The use of meshed STSGs allows blood and edematous fluid to drain, leading to reduced healing time as well as reduced incidence of seroma and hematoma formation5,6. Additionally, meshed grafts may also be stretched to provide added area of coverage, which is essential in full body burns where donor site availability is limited. However, excessive tension on the meshed graft may result in additional skin contracturing, leading to a decreased range of motion along with a scale-like appearance11. Long-term postoperative reviews have shown that tension free meshed grafts have a superior aesthetic result when compared to stretched meshed grafts6. This study plans to retrospectively compare the functional and cosmetic outcomes of hand burn patients who were treated with 1:1 Meshed STSG to those who were treated with traditional STSG grafts.
Methods:
Total of 46 Patient screened for inclusion criteria de-indentified. The chart review and data collection of occupation therapy and physical therapy review of range of motion collected in regards to postoperative hand function. IRB approved Aesthetic survey performed show photographs of hand burns ranging from 3 months postoperative to 1 year postoperative.
Results:
Comparison of aesthetic and functional post-surgical outcomes for hand burn patients receiving 1:1 Meshed STSG to those who were treated with STSG.have similar functional outcomes to those receiving STSG, and if the 1:1 Meshed modification of the STSG reduces the formation of recognizable scar patterns. The 1:1 Meshed STSG modification will provide a functional advantage over traditional STSG by avoiding scarring and contracture and improve range of motion.
Conclusion:
This study will faciitate additional breadth of knowledge in treating hand burns utlizling 1:1 meshed STSG. Our study can serve as a pilot towards establishing standard of care for hand-burn patients receiving skin grafts.