Recalcitrant Bilateral Volar Hand Burn Contracture in a Toddler Treated With Integra and Staged Full-thickness Skin...

Area of Science:

• Reconstructive surgery
• Pediatric burn management
• Tissue engineering

Background:

• Recurrent burn contractures on the volar hand are challenging, particularly in children.
• Integra (a dermal regeneration template) combined with skin grafting is a potential treatment.
• The utility of full-thickness skin grafting (FTSG) with Integra for these contractures requires further investigation.

Purpose of the Study:

• To evaluate the effectiveness of Integra followed by staged FTSG for recurrent bilateral volar hand burn contracture in a pediatric patient.
• To systematically review the literature on the use of Integra and skin substitutes for palmar hand contractures and wounds.

Main Methods:

• A systematic literature review was conducted on Integra and skin substitutes for palmar hand contractures and wounds.
• A case report details the treatment of a pediatric patient with recurrent bilateral burn flexion contracture using Integra followed by staged FTSG.
• Literature search identified 92 publications on volar hand defects; 10 discussed Integra, with only 2 using FTSG with Integra.

Main Results:

• The systematic review found limited previous reports on using Integra combined with FTSG for postburn volar hand flexion contractures.
• The case report describes a successful application of Integra followed by FTSG in a pediatric patient.
• Only two studies in the literature utilized FTSG in combination with Integra for volar hand defects.

Conclusions:

• The application of FTSG to vascularized Integra may offer protection against recurrent burn contractures of the palmar hand in pediatric patients.
• This case report suggests a promising approach, but further research is needed to validate the findings.
• The combination of Integra and FTSG for recurrent volar hand burn contractures has not been previously reported in the literature.