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The use of the modified Thomas splint for a patient with cultured epidermal autografts
A Bolgiani1, O Patino, F Benaim
1Rehabilitation Department, Klgo. Ftra. Osvaldo Patino, Rehabilitation Department, Buenos Aires, Argentina.
Unlabelled:
Because of the difficulty in handling a patient with cultured epidermal autografts in pressure areas of the limbs, we have adopted a splint that is easy to apply, allows an easy access to the wound, and is well tolerated by the patient.
Hypothesis:
Avoiding pressure in areas with autografts is recommended. This is the reason we have used a splint that avoids the pressure and the secretion buildup. This technique helps a better "take of the grafts."
Methods:
We have modified the original Thomas splint in two ways: (1) the use of a distant and upper appliance that allows to correct the foot's flexion; and (2) the use of an appliance that can be regulated, is inflatable, and can be removed, allowing the change of pressure in different areas. We have used this method with one patient with a deep degree of circumferential burn in both lower limbs. The splint has been maintained and the elevation changed every day for 15 days. Traction has been made with the use of the Kirschner stirrup.
Results:
The dressing was changed easily and without patient pain. Good mobility was possible, with genital hygiene and grafts that were taken in 70% of the cultured epidermal autografts.
Conclusion:
This method allows maintenance of the legs in functional position during dressing changes and avoids pressure and chafing. It decreases the loss of the autograft for mechanical effects.