4th degree burn debridement skin#

The fingers of both hands and toes of both feet were carbonized, presenting as branch-like dry necrosis ( Figure 1). When the 4 extremities were incised to reduce tension, muscular eversion and necrosis were seen in part of the median sides of the upper limbs and thighs, and lateral sides of the calves, the left arm being the most serious.

4th degree burn debridement skin#

Except for a small piece of unburned skin on the posterior head measuring about 0.5% TBSA, the rest of the scalp and the face suffered deep second degree burns, and the trunk and the 4 extremities were full of black eschar. Thirty hours after fluid resuscitation in a local hospital, he was referred to our hospital, when the patient was conscious and the vital signs were relatively stable. The patient is a 29-year-old male who was seriously burned by molten steel (about 1,500☌) from the top of the head throughout the body, in an accidental furnace explosion. The patient was observed for 2 years, and the quality of life is evaluated. This article is a summary of our experience with the treatment of a patient with an extraordinarily large deep burn (99.5% TBSA and 23% fourth degree burn) by using the “microskin autografting and alloskin repeated grafting” method to close the wound because of scarcity of skin sources. Even though the patient is saved, the patient’s quality of life remains an increasing concern, both on the part of clinicians and society. Autologous transplantation of cultured keratinocytes can provide adequate skin sources for wound closure, but the long cultivation time, high cost and rigorous technology requirements limit its application in developing countries. Therefore, micro-skin autografting is more suitable for application to severely burned patients who have a scarcity of skin sources. MEEK skin grafting can expand the donor skin by 3–9 times, and micro-skin autografting can do this 10–15 times larger.

For extensive severe burn wounds repair, there are 3 major solutions: MEEK skin grafting, Chinese-originated micro-skin autografting, and transplantation of cultured epidermal cells. However, in patients with a scarcity of skin sources, treatment of large fourth degree burns remains a great clinical challenge. The salvage rate of large burns has improved steadily in the past 10 years in China.