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Clinical Therapeutic Effect of Sheet Split-Thickness Skin Graft with Micropores in Repairing Third-Degree Burn Wounds on the Hands

Xiaopeng Zheng, Tiansheng Chen, Lisen Zhang, Ruibin Cheng, Fei Chang, Shizhao Ji, Yu Sun, Xiaoyan Hu, Shichu Xiao, Zhaofan Xia

Med Sci Tech 2016; 57:74-80

DOI: 10.12659/MST.900085


BACKGROUND: Sheet split-thickness skin grafting is the main method used to repair the third-degree burn wounds on the hands. However, because of the poor drainage of sheet skin, there is often subcutaneous effusion after sheet grafting, which can form hematomas and seromas, leading to partial necrosis of the grafted skin, and critically affect the appearance and function of the hand. Thus, there is urgent need to find a more stable method to improve the survival rate of the grafted skin.
MATERIAL AND METHODS: Sixty-two cases with third-degree hand burns were collected from 2010 to 2014 in the Burn and Trauma Center of Changhai Hospital in Shanghai and in the Burns Department of the 100th Hospital of the PLA in Suzhou city. According to the methods of skin grafts, the cases were divided into treatment group (sheet split-thickness skin graft with micropores) and control group (sheet split-thickness skin graft without micropores). Subcutaneous hematomas and seromas were observed, and the rate of graft loss was calculated. All cases were followed up for 1 year to assess the scar formation. Animal experiments were performed to observe the changes of the micropore size and the collagen arrangement at the micropore region after sheet split-thickness skin graft with micropores.
RESULTS: There were 32 cases were in the treatment group and 30 in the control group. One week after the operation, the incidence of subcutaneous hemorrhages and seromas in the treatment group (46.9%) was significantly lower than in the control group (73.3%), and the difference has statistical significance (P<0.05). Compared with that of the control group ((5.62±3.28)%), the average rate of graft loss of the treatment group ((5.62±3.28)%) was obviously lower, and the difference was statistically significant (P<0.05). The VSS scores of the treatment group in the 3rd, 6th, and 12th months (4.94±1.52, 3.34±1.49, 2.59±1.34) were lower than that of the control group at the same point in time (6.57±1.48, 4.83±1.46, 3.37±1.43), and the differences were statistically significant (P<0.05). The UNC4P scores of the treatment group were lower than that of the control group in the 3rd month (4.94±1.72 vs. 6.83±1.46), the 6th month (3.28±1.44 vs. 4.40±1.54), and the 12th month (1.37±0.24 vs. 3.07±1.55), and the differences were statistically significant (P<0.05).
CONCLUSIONS: In repairing of the third-degree hand burns, sheet split-thickness skin graft with micropores performed better in decreasing the incidence of subcutaneous hematomas and seromas than sheet split-thickness skin graft without micropores. Use of skin grafts with micropores could improve the survival rate of grafted skin, as well as the appearance and function of the hand after wound healing.

Keywords: Burns, Cicatrix, hand injuries, Micropore Filters, Skin Transplantation

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