Background:Autologous split skin grafting is the gold standard in treating patients with massive burns.However,the limited availability of donor sites remains a problem.The aim of this study is to present our experien...Background:Autologous split skin grafting is the gold standard in treating patients with massive burns.However,the limited availability of donor sites remains a problem.The aim of this study is to present our experience with the modified Meek technique of grafting,outcomes achieved and recommendations for optimized outcomes.Methods:We retrospectively reviewed patient records from our tertiary referral burn centre and the Bi-National Burns Registry to identify all patients who had modified Meek grafting between 2010 and 2013.Patient records were reviewed individually and information regarding patient demographics,mechanism of injury and surgical management was recorded.Outcome measures including graft take rate,requirement for further surgery and complications were also recorded.Results:Eleven patients had modified Meek grafting procedures.The average age of patients was 46 years old(range 23–64).The average total body surface area(TBSA)burnt was 56.75%(range 20–80%).On average,87%of the grafted areas healed well and did not require regrafting.In the regrafted areas,infection was the leading cause of graft failure.Conclusions:Modified Meek grafting is a useful method of skin expansion.Similar to any other grafting technique,infection needs to be sought and treated promptly.It is recommended for larger burns where donor sites are not adequate or where it is desirable to limit their extent.展开更多
Background:Patients presenting with large surface area burns are common in our practice;however, patients with a secondary large burn on pre-existing burn scars and grafts are rare and not reported. Case presentation:...Background:Patients presenting with large surface area burns are common in our practice;however, patients with a secondary large burn on pre-existing burn scars and grafts are rare and not reported. Case presentation:We report on an unusual case of a patient sustaining a secondary large burn to areas previously injured by a burn from a different mechanism. We discuss the potential implications when managing a case like this and suggest potential biological reasons why the skin may behave differently. Our patient was a 33-year-old man who presented with a 5%TBSA burn on skin scarred by a previous 40%total body surface area (TBSA) burn and skin grafts. Initially assessed as superficial partial thickness in depth, the wounds were treated conservatively with dressings;however, they failed to heal and became infected requiring surgical management. Conclusions:Burns sustained in areas of previous burn scars and grafts may behave differently to normal patterns of healing, requiring more aggressive management and surgical intervention at an early stage.展开更多
基金We thank John Mills MD FACP FRACP ARCPA(Faculty of Medicine,Monash University,Macfarlane Burnet Institute for Medical Research and Public Health,Melbourne,Australia)for his input with statistical analyses
文摘Background:Autologous split skin grafting is the gold standard in treating patients with massive burns.However,the limited availability of donor sites remains a problem.The aim of this study is to present our experience with the modified Meek technique of grafting,outcomes achieved and recommendations for optimized outcomes.Methods:We retrospectively reviewed patient records from our tertiary referral burn centre and the Bi-National Burns Registry to identify all patients who had modified Meek grafting between 2010 and 2013.Patient records were reviewed individually and information regarding patient demographics,mechanism of injury and surgical management was recorded.Outcome measures including graft take rate,requirement for further surgery and complications were also recorded.Results:Eleven patients had modified Meek grafting procedures.The average age of patients was 46 years old(range 23–64).The average total body surface area(TBSA)burnt was 56.75%(range 20–80%).On average,87%of the grafted areas healed well and did not require regrafting.In the regrafted areas,infection was the leading cause of graft failure.Conclusions:Modified Meek grafting is a useful method of skin expansion.Similar to any other grafting technique,infection needs to be sought and treated promptly.It is recommended for larger burns where donor sites are not adequate or where it is desirable to limit their extent.
文摘Background:Patients presenting with large surface area burns are common in our practice;however, patients with a secondary large burn on pre-existing burn scars and grafts are rare and not reported. Case presentation:We report on an unusual case of a patient sustaining a secondary large burn to areas previously injured by a burn from a different mechanism. We discuss the potential implications when managing a case like this and suggest potential biological reasons why the skin may behave differently. Our patient was a 33-year-old man who presented with a 5%TBSA burn on skin scarred by a previous 40%total body surface area (TBSA) burn and skin grafts. Initially assessed as superficial partial thickness in depth, the wounds were treated conservatively with dressings;however, they failed to heal and became infected requiring surgical management. Conclusions:Burns sustained in areas of previous burn scars and grafts may behave differently to normal patterns of healing, requiring more aggressive management and surgical intervention at an early stage.
