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KMID : 0853020070100010060
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Journal of Korean Burn Society
2007 Volume.10 No. 1 p.60 ~ p.64
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Clinical Review of Burn Scar Contracture Reconstruction using Integra® with Thin Split Thickness Skin Grafting
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Choi Dong-Hwi
Kim Se-Yeon
Lee Joo-Bong
Jeong Cheol-Soo
Kim Hae-Young
Huh Gi-Yeong
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Abstract
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Backgrounds: Integra Integra®, bilayered dermal substitute, was initially developed for covering of acute burn wounds. In addition, it can be used in reconstruction of burn scar contracture. We present our experiences of using Integra? as a tool for reconstruction of burn scar contractures.
Methods: The authors present a series of 14 patients who underwent reconstructive surgery with Integra? grafting for a total of 20 operational sites. Initially we excised burn scar and grafted Integra Integra®. After formation of neodermis, the silicon layer is removed and replaced with thin split thickness skin graft. We assessed data on contracture site, skin graft time after application of Integra?, infection rate, postoperative function and appearance, patient satisfaction, adverse events, histology and follow up period.
Results: The average area grafted per procedure was 366.3 cm2 (80∼800). The operation sites were located on trunk and extremities including joints. The average time between application of Integra Integra® and thin split thickness skin graft was about 19.15 days (14∼21). In 4 operational sites, focal infections of Integra Integra® were observed at margins and the area of hematoma, and then followed by unroofing with Iris scissors and treated with Acticoat dressings. Functional outcomes and patient satisfactions were favorable and the color and texture of the reconstruction sites were very good, except in 5 cases, which slightly hypertrophic scars recurred at borderline between covering with Integra® and normal skin. The mean follow up period was 7.45 months (1∼14), and in a case of 14th months follow up, the histology was stable epithelium and dermal collagen which were indistinguishable from normal skin.
Conclusions: Integra Integra® with thin split thickness skin grafting appears as a useful reconstructive tool of burn scar contracture release procedure. Furthermore, Integra? confers funtional and aesthetic benefits similar to those of full thickness grafts. But the long term follow up will be necessary to assess the complete applications of this technique.
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KEYWORD
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Burn scar contracture reconstruction, Integra®, Thin split thickness skin graft
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