Skin graft as a modality reconstruction of post-burn contractures during pandemic area: case series

Ulfa Elfiah; David Sontani Perdanakusuma; Iswinarno Dososaputra; I Nyoman Riasa; Loelita Marcelia Lumintang; Muhammad Fahmi Naufal

doi:10.15562/bmj.v12i1.4003

Skin graft as a modality reconstruction of post-burn contractures during pandemic area: case series

Ulfa Elfiah ,

David Sontani Perdanakusuma ,

Iswinarno Dososaputra ,

I Nyoman Riasa ,

Loelita Marcelia Lumintang ,

Muhammad Fahmi Naufal ,

pdf |
DOI: https://doi.org/10.15562/bmj.v12i1.4003 |
Published: 2023-01-11

Abstract

Background: The Covid-19 pandemic causes the postponement of elective surgery. At the same time, patients with post-burn contractures require immediate operation due to impaired function that can lead to depression and disruption of daily life. Operations on contracture patients during a pandemic must be carried out using the principles of accuracy, speed, and safety. The skin graft is one of the most appropriate treatments modalities for releasing contractures. This case study aims to evaluate the skin graft as a modality reconstruction of post-burn contractures during pandemic area.

Case Presentation: We present three cases of post-burn contractures who underwent contracture release and skin graft surgery with a hospital stay of 3-5 days. Surgical results showed that graft take reached 90%-100% in all patients, and 100% epithelialization occurred at donor sites between 2-4 weeks postoperatively. There were no post-operative complications.

Conclusion: The skin graft is an effective and suitable technique for treating post-burn contractures in the pandemic era.

References

Sarac BA, Schoenbrunner AR, Wilson SC, Chiu ES, Janis JE. The Impact of COVID-19-based Suspension of Surgeries on Plastic Surgery Practices: A Survey of ACAPS Members. Plast Reconstr Surg - Glob Open. 2020;8(8):1–6.
Fuertes V, Monclús E, Agulló A. Current impact of Covid-19 pandemic on Spanish plastic surgery departments: a multi-center report. Eur J Plast Surg. 2020;43(4):483–490.
Sison-Williamson M, Bagley A, Palmieri T. Long-term post-operative outcomes after axillary contracture release in children with burns. J Burn Care Res. 2012; 33(2):228–234.
Saaiq M, Zaib S, Ahmad S. The menace of post-burn contractures: A developing country's perspective. Ann Burns Fire Disasters. 2012; 25(3):152–8.
Fufa DT, Chuang SS, Yang JY. Postburn contractures of the hand. J Hand Surg Am. 2014;39(9):1869–1876.
Seo DK, Kym D, Hur J. Management of neck contractures by single-stage dermal substitutes and skin grafting in extensive burn patients. Ann Surg Treat Res. 2014;87(5):253–259.
Walsh K, Nikkhah D, Dheansa B. Burn Scar Contractures & Their Management.Plastic and Reconstructive Surgery. 2013;3:25–31.
Pham TN, Goldstein R, Carrougher GJ, Gibran NS, Goverman J, Esselman PC, et al. The impact of discharge contracture on return to work after burn injury: A Burn Model System investigation. Burns. 2020;46(3):539–545.
Dogra B, Kataria M, Kandari A, Ahmed S, Singh A, Virmani R. Management of postburn contractures of upper extremities: A general surgeon's perspective. Indian J Burn. 2016;24(1):29.
Hayashida K, Akita S. Surgical treatment algorithms for post-burn contractures. Burn Trauma. 2017;5:1–8.
Mujahid AM, Tarar FA, Khalid FA, Sajjad Y, Ishaque U, Tarar MN. Outcome of successful graft take of Integra and split thickness skin graft after the release of post-burn neck contracture. Prof Med J. 2021;28(01):106–112.
Bhatnagar A, Singh A. The postburn severe flexion contracture neck correction with split-thickness skin graft: Our experience. Indian J Burn. 2020;28(1):36.
Luo X, Liu F, Wang X, Yang Q, Wang S, Zhou X, et al. Region-oriented and staged treatment strategy in reconstruction of severe cervical contracture. PLoS One. 2015;10(4):e0122669.
Samal CC, Dash S, Agrawal K, Tandon R. Comparative evaluation of three methods of skin graft fixation for split thickness skin graft after release of post burn contracture of the neck. Burns. 2019;45(3):691–698.
Prabawa IMY, Silakarma D, Prabawa IPY, Manuaba IBAP. Physical Rehabilitation Therapy for Long COVID-19 Patient with Respiratory Sequelae: A Systematic Review. Open Access Maced J Med Sci. 2022;10(F):468-474.
Hariharan N, Sridhar R, Sankari B, Valarmathy VS, Asirvatham E, Geetha K. Reconstruction of postburn crippled hands: A study of functional outcome. Indian J Burn. 2018;26(1):9.
Rajan M, Tyagi A, Dvivedi S, Rawat KA. Management and outcome in patients with post burn contracture. Int Surg J. 2018;6(1):42.
Muhammad K, Prasetyo A, Prajoko YW, Najatullah N, Susilaningsih N. Effectiveness of nanosilver collagen cream for healing deep dermal burns in Sprague Dawley rats: an overview of neutrophil counts and angiogenesis. Bali Medical Journal. 2021;10(2):648–652.
Borse HG, Guin AN. Study of Split Thickness Skin Grafting in Management of Post Burn Contracture. MVP J Med Sci. 2017;4:180–185.

[1] Sarac BA, Schoenbrunner AR, Wilson SC, Chiu ES, Janis JE. The Impact of COVID-19-based Suspension of Surgeries on Plastic Surgery Practices: A Survey of ACAPS Members. Plast Reconstr Surg - Glob Open. 2020;8(8):1–6.

[2] Fuertes V, Monclús E, Agulló A. Current impact of Covid-19 pandemic on Spanish plastic surgery departments: a multi-center report. Eur J Plast Surg. 2020;43(4):483–490.

[3] Sison-Williamson M, Bagley A, Palmieri T. Long-term post-operative outcomes after axillary contracture release in children with burns. J Burn Care Res. 2012; 33(2):228–234.

[4] Saaiq M, Zaib S, Ahmad S. The menace of post-burn contractures: A developing country's perspective. Ann Burns Fire Disasters. 2012; 25(3):152–8.

[5] Fufa DT, Chuang SS, Yang JY. Postburn contractures of the hand. J Hand Surg Am. 2014;39(9):1869–1876.

[6] Seo DK, Kym D, Hur J. Management of neck contractures by single-stage dermal substitutes and skin grafting in extensive burn patients. Ann Surg Treat Res. 2014;87(5):253–259.

[7] Walsh K, Nikkhah D, Dheansa B. Burn Scar Contractures & Their Management.Plastic and Reconstructive Surgery. 2013;3:25–31.

[8] Pham TN, Goldstein R, Carrougher GJ, Gibran NS, Goverman J, Esselman PC, et al. The impact of discharge contracture on return to work after burn injury: A Burn Model System investigation. Burns. 2020;46(3):539–545.

[9] Dogra B, Kataria M, Kandari A, Ahmed S, Singh A, Virmani R. Management of postburn contractures of upper extremities: A general surgeon's perspective. Indian J Burn. 2016;24(1):29.

[10] Hayashida K, Akita S. Surgical treatment algorithms for post-burn contractures. Burn Trauma. 2017;5:1–8.

[11] Mujahid AM, Tarar FA, Khalid FA, Sajjad Y, Ishaque U, Tarar MN. Outcome of successful graft take of Integra and split thickness skin graft after the release of post-burn neck contracture. Prof Med J. 2021;28(01):106–112.

[12] Bhatnagar A, Singh A. The postburn severe flexion contracture neck correction with split-thickness skin graft: Our experience. Indian J Burn. 2020;28(1):36.

[13] Luo X, Liu F, Wang X, Yang Q, Wang S, Zhou X, et al. Region-oriented and staged treatment strategy in reconstruction of severe cervical contracture. PLoS One. 2015;10(4):e0122669.

[14] Samal CC, Dash S, Agrawal K, Tandon R. Comparative evaluation of three methods of skin graft fixation for split thickness skin graft after release of post burn contracture of the neck. Burns. 2019;45(3):691–698.

[15] Prabawa IMY, Silakarma D, Prabawa IPY, Manuaba IBAP. Physical Rehabilitation Therapy for Long COVID-19 Patient with Respiratory Sequelae: A Systematic Review. Open Access Maced J Med Sci. 2022;10(F):468-474.

[16] Hariharan N, Sridhar R, Sankari B, Valarmathy VS, Asirvatham E, Geetha K. Reconstruction of postburn crippled hands: A study of functional outcome. Indian J Burn. 2018;26(1):9.

[17] Rajan M, Tyagi A, Dvivedi S, Rawat KA. Management and outcome in patients with post burn contracture. Int Surg J. 2018;6(1):42.

[18] Muhammad K, Prasetyo A, Prajoko YW, Najatullah N, Susilaningsih N. Effectiveness of nanosilver collagen cream for healing deep dermal burns in Sprague Dawley rats: an overview of neutrophil counts and angiogenesis. Bali Medical Journal. 2021;10(2):648–652.

[19] Borse HG, Guin AN. Study of Split Thickness Skin Grafting in Management of Post Burn Contracture. MVP J Med Sci. 2017;4:180–185.

Skin graft as a modality reconstruction of post-burn contractures during pandemic area: case series

Abstract

References

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