Skin stretching for primary closure of acute burn wounds

Abstract Background In burn care, a well-acknowledged problem is the suboptimal scar outcome from skin grafted burn wounds. With the aim of improving this, we focused on a new technique: excision of the burn wound followed by primary closure, thereby using a skin-stretching device to stretch the adj...

Full description

Saved in:
Bibliographic Details
Published in:Burns 2014-12, Vol.40 (8), p.1727-1737
Main Authors: Verhaegen, Pauline D.H.M, Bloemen, Monica C.T, van der Wal, Martijn B.A, Vloemans, Adrianus F.P.M, Tempelman, Fenike R.H, Beerthuizen, Gerard I.J.M, van Zuijlen, Paul P.M
Format: Article
Language:English
Subjects:
Adult
Aged
Burns
Burns - complications
Burns - surgery
Cicatrix - etiology
Cicatrix - pathology
Cicatrix - surgery
Critical Care
Female
Humans
Male
Middle Aged
Primary closure
Randomized controlled trial
Skin stretching
Tissue Expansion - methods
Wound Healing
Wounds
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background In burn care, a well-acknowledged problem is the suboptimal scar outcome from skin grafted burn wounds. With the aim of improving this, we focused on a new technique: excision of the burn wound followed by primary closure, thereby using a skin-stretching device to stretch the adjacent healthy skin. The short- and long-term effect of Skin Stretch was compared to split skin grafting (SSG) in a randomized controlled trial. Methods Patients with burn wounds were randomized for SSG or primary wound closure using Skin Stretch. Follow-up was performed at 3 and 12 months postoperatively. The scar surface area was calculated and the scar quality was assessed, using subjective and objective measurement methods. Results No significant differences between the SSG and the Skin Stretch group were found for scar surface area. In the Skin Stretch group, a significant reduction of the surface area from 65.4 cm2 (13.6–129.1) to 13.4 cm2 (3.0–36.6) was found at 3 months ( p = 0.028) and at 12 months postoperatively (65.4 cm2 (13.6–129.1) to 33.0 cm2 (8.9–63.7), p = 0.046, Wilcoxon signed ranks test). Conclusions Skin Stretch for primary closure of acute burn wounds is a suitable technique and can be considered for specific circumscript full-thickness burn wounds. However, future research should be performed to provide additional scientific evidence.
ISSN:0305-4179
1879-1409
DOI:10.1016/j.burns.2014.03.014