gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Split thickness skin graft from the instep region: no recommendation in pediatric palmar burn

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  • presenting/speaker Evi M. Morandi - Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria
  • Christoph Tasch - Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria
  • Elisabeth Schwabegger - Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria
  • Gabriel Djedovic - Department of Plastic, Reconstructive and Aesthetic Surgery, Academic Hospital Feldkirch, Feldkirch, Austria
  • Gerhard Pierer - Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria
  • Eva Maria Baur - Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1355

doi: 10.3205/19ifssh0411, urn:nbn:de:0183-19ifssh04117

Published: February 6, 2020

© 2020 Morandi et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Contact burn injuries to the palm are a common in toddlers. Full-thickness burns without signs of reepithelization after two weeks need to be skin grafted. The use of split thickness skin grafts from the instep region of the foot has been recommended in adults in order to replace like with like". While split thickness skin grafts from the instep region might show an excellent color match and the texture of glabrous skin, they are prone to scar contraction in pediatric patients.

Methods: We performed a retrospective analysis of all pediatric patients who were referred to our hospital between January 2009 and December 2017 due to a contact burn injury of the palm. Among 109 contact burn injuries in total, 82 patients were between 0 and 4 years old (mean age: 21 months, range: 7-48 months) representing the typical age group concerned by contact burns and were included in the study (n=82 patients).

Results and Conclusions: In this case series, we critically discuss the use of split thickness skin grafts from the instep region and explain our concerns about the use of split skin technique in children.

Full thickness skin grafts remain the reference standard of care in pediatric patients. Children with burn scars should have regular check-up examinations until they are grown up.