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Full thickness skin graft versus split thickness skin graft in paediatric patients with hand burns: Systematic review

Abdulmalik Alsaif1, Mohammad Karam2, Amrit Hayre3

  • 1MBChB, Walsall Healthcare NHS Trust, West Midlands, UK.

Burns : Journal of the International Society for Burn Injuries
|October 24, 2022
PubMed

Insights

Full thickness skin grafts significantly reduce contractures and surgical releases in pediatric hand burns compared to split thickness grafts. While split thickness grafts offer better cosmetic outcomes, full thickness grafts provide superior functional results.

Area of Science:

  • Reconstructive surgery
  • Pediatric burn care
  • Wound healing

Background:

  • Hand burns in children present unique challenges for reconstructive surgery.
  • Grafting techniques, including full thickness skin grafts (FTSG) and split thickness skin grafts (STSG), are crucial for optimal outcomes.
  • Comparing FTSG and STSG in pediatric hand burns is essential for guiding clinical practice.

Approach:

  • A systematic review and meta-analysis adhering to PRISMA guidelines was conducted.
  • Electronic searches identified randomized controlled trials and non-randomized studies comparing FTSG and STSG in pediatric hand burn patients.
  • Fixed effects modeling was applied for data analysis.

Key Points:

  • FTSG demonstrated a statistically significant reduction in post-graft contracture and the need for subsequent surgical release compared to STSG.
  • FTSG showed superior post-operative functional ability in pediatric hand burn patients.
  • STSG resulted in better scar, aesthetic, and color assessments, with less observed hair growth.

Conclusions:

  • FTSG represent a superior alternative to STSG for pediatric hand burns, primarily due to reduced contracture formation and fewer required surgical interventions.
  • While STSG may offer cosmetic advantages, the functional benefits and reduced complication rates of FTSG make them preferable in this patient population.
  • Further research may explore optimizing FTSG techniques to mitigate their cosmetic limitations.

Keywords:
ContractureFull thickness skin graftSplit thickness skin graftSurgical release

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