Preserved Superficial Fat Skin Composite Graft for Correction of Burn Scar Contracture of Hand.

Son, Daegu; Jeong, Hoijoon; Choi, Taehyun; Kim, Junhyung; Han, Kihwan

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2008;35(6):716-722.
Published online November 1, 2008.

Preserved Superficial Fat Skin Composite Graft for Correction of Burn Scar Contracture of Hand.

Daegu Son, Hoijoon Jeong, Taehyun Choi, Junhyung Kim, Kihwan Han

Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine, Daegu, Korea. handson@dsmc.or.kr

Abstract

PURPOSE
Split or full thickness skin graft is generally used to reconstruct the palmar skin and soft tissue defect after release of burn scar flexion contracture of hand. As a way to overcome and improve aesthetic and functional problems, the authors used the preserved superficial fat skin(PSFS) composite graft for correction of burn scar contracture of hand. METHODS: From December of 2001 to July of 2007, thirty patients with burn scar contracture of hand were corrected. The palmar skin and soft tissue defect after release of burn scar contracture was reconstructed with the PSFS composite graft harvested from medial foot or below lateral and medial malleolus, with a preserved superficial fat layer. To promote take of the PSFS composite graft, a foam and polyurethane film dressing was used to maintain the moisture environment and Kirschner wire was inserted for immobilization. Before and after the surgery, a range of motion was measured by graduator. Using a chromameter, skin color difference between the PSFS composite graft and surrounding normal skin was measured and compared with full thickness skin graft from groin.
RESULTS
In all cases, the PSFS composite graft was well taken without necrosis, although the graft was as big as 330mm2(mean 150mm2). Contracture of hand was completely corrected without recurrence. The PSFS composite graft showed more correlations and harmonies with surrounding normal skin and less pigmentation than full thickness skin graft. Donor site scar was also obscure.
CONCLUSION
The PSFS composite graft should be considered as a useful option for correction of burn scar flexion contracture of hand.

Keywords: Composite graft; Burn scar contracture; Chronometry

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