Long-term effects of moisturizing and desecrasing combined with autologous large and medium thickness skin graft for re-pairing deep hand burn wounds
XU Pei
ZHANG Hongling
TONG Huan
LONG Zhongheng
ZHANG Xiangming
Abstract：Objective To investigate the long-term effects of moisturizing and desecscating combined with autologous large and thick skin graft for repairing deep hand burn wounds.Methods A retrospective systematic case study was conducted to analyze 18 pa-tients(30 hands)with burns complicated with deep hand burns admitted to Department of Skin Wound Repair Center,Tongren Hospital of Wuhan University&Wuhan Third Hospital from January 2015 to December 2021.with total burn area ≤30％TBSA and normal skin on chest,back and head.The wound depth of hand was Ⅱ °～Ⅲ°.without tendon and/or bone exposure.Hand wounds were washed and dis-infected with 0.2％～0.3％iodophor,and moisturized and dressed with silver sulfadiazine(SD-Ag)cream and vaseline gauze once every other day.The obvious necrotic tissue on the wounds was removed in time during dressing change.About 3 weeks after the injury,necrotic scab and new granulation tissue were shed on the wound surface of the hand.Large and thick skin grafts on the back of the chest were used to repair the wound surface,covering more than the metacarpophalangeal joint,including some deep wounds on the back of the finger.Thick stamp skin grafts on the head were used to repair the donor skin area of the back of the chest.Early rehabilitation exercise and pre-vention of scar hyperplasia after hand wound healing.The survival of hand skin graft was observed and recorded.Hand function was as-sessed by Carroll upper limb function assessment criteria.Results All the burns healed in 18 patients.Thirty deep wound autografts sur-vived well without infection.The skin donor area of the head healed well,and the scar hyperplasia of the chest and back was light.The pa-tients were followed up for 1 to 5 years.There was no obvious scar hyperplasia of the hand,no dorsiflexion deformity of the metacarpopha-langeal joint,and the shape and function of the hand recovered well.Carroll's hand function scores ranged from 90 to 99,reaching V and VI.Conclusion Moisturizing and desecscating combined with autologous large and medium thickness skin transplantation is a good method for repairing deep burn wounds of hands.The degree of scar hyperplasia and contracture on wound healing is light,the long-term effect is significant,and the shape and function of hands are better.
Keywords：Deep burnTransplantationHandMedium thickness skin graftLargeDecrustation
Publication Date：2024-07-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 402-404,410 )