Page 293 - Read Online

Madiedo et al. Plast Aesthet Res 2018;5:40 Plastic and
DOI: 10.20517/2347-9264.2018.40 Aesthetic Research

Original Article Open Access

Applying skin graft sheets transversely to manage
burn patients

Ricardo Madiedo , Jorge Luis Gaviria-Castellanos , Alejandro Zapata-Ospina 2
1
1
1 Cosmetic and Reconstructive Plastic Surgeon, Burn Unit Simón Bolívar North Subnetwork E.S.E., Bogotá D.C. 110221, Colombia.
2 Department of Plastic Surgery, University of Sinú, Cartagena 110231, Colombia.

Correspondence to: Dr. Ricardo Madiedo, Cosmetic and Reconstructive Plastic Surgeon, Burn Unit Simón Bolívar North Subnetwork
E.S.E., Bogotá D.C. 110221, Colombia. E-mail: madiedor@hotmail.com

How to cite this article: Madiedo R, Gaviria-Castellanos JL, Zapata-Ospina A. Applying skin graft sheets transversely to manage burn
patients. Plast Aesthet Res 2018;5:40. http://dx.doi.org/10.20517/2347-9264.2018.40

Received: 4 Jun 2018 First Decision: 14 Aug 2018 Revised: 30 Aug 2018 Accepted: 4 Sep 2018 Published: 11 Oct 2018
Science Editor: Raúl González-García Copy Editor: Cui Yu Production Editor: Zhong-Yu Guo

Abstract

Aim: The aim of this study is to determine whether the split-thickness grafts should be applied to the treatment of burn
patients, parallel to the relaxed skin tension lines as described by Kraissl, which would help scarring and reduce the
development of abnormal scars.

Methods: A descriptive longitudinal case series study was conducted at the Burn Unit of Health Services Simón Bolívar
North Subnetwork E.S.E. of the Secretariat of Health in Bogotá, Colombia, from 1 Jan 2016 to 31 Dec 2017. A total
of 138 burn patients exhibiting deep partial- or full-thickness burns involving different body regions, except for the
face, were included. Burns required split-thickness skin grafts for definite wound coverage, and these were applied
transversely following relaxed skin tension lines. Results were assessed according to the Vancouver Scar Scale (VSS)
during a 12-month follow-up. Within this period, function was assessed by the rehabilitation unit, after which physical
and functional activities were determined and splinting was implemented, as per rehabilitation protocols, to control and
improve functional and physical outcomes.

Results: Based on the VSS, most patients (134) had a mean score of 5 (range: 3-7), resulting in clinically acceptable scars
with no functional limitations.

Conclusion: Applying split-thickness skin grafts to cover deep partial- or full-thickness burns along relaxed skin tension
lines, such as Kraissl’s lines, seems to reduce wound tension force, which constitutes one of the most predominant
factors contributing to the development of abnormal scars and functional sequelae.

Keywords: Split-thickness grafts, burns, relaxed skin tension lines, hypertrophic scar, keloid, contracture

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.parjournal.net