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Burns Treatment

Procedures Procedure

Authors: Rami Mossad Ibrahim, MD, Elisabeth Lauritzen, MD, Frederik Gulmark, Hansen Med. Stud., Anne Mosebo, Med. Stud., Magnus Balslev Avnstorp, MD and Rikke Holmgaard, MD, PhD

Skin grafts can be harvested from all parts of the body, however, first choice is usually from the thigh – avoiding joints.

In children and for grafting of the face, the scalp is a suitable donor site. The scalp comprise thick skin and the hair follicles are therefore preserved when harvesting.

Depending on the donor/recipient size, the mesh-ratio can be:

  • 1:1
  • 1:1,5
  • 1: 3
  • 1:6
  • 1:9

Mesh holes serve as drainage and will prevent blood/fluid formation under the graft. A skin graft can be stored in a refrigerator for 10-14 days before application, however, the risk of graft loss increases over time.

Procedure

The recipient site must be as clean as possible i.e. no infection, necrosis or bleeding.

Staples

  • Are placed to keep the graft in place and to ensure complete fixation

Absorbable sutures

  • Can be used for children or in complicated recipient sites such as on eyelids or perineum
  • Note that the absorbable sutures can increase the risk of infection

Non-resorbable sutures

  • Ensure the position of the graft until removed
  • The sutures have to be removed after 5-14 days depending on how well the graft heals

Histoacryl

  • Is tissue glue that can help fixate the graft
  • It is mostly used in the face or on the hands
  • Is easily applied and will not have to be removed

Bandage

  • The donor site can be bandaged with 2 layers of vaseline gauze, dry gauze and bandage or Allevyn and Opsite (Fig. 15)
  • The reciepient site can be bandaged with Nitrofurazone gauze and Jelonet gauze combined with a foam compression on top (Fig. 16)

Procedure and cases

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Cleaning the burn

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Applying bandages

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Surgical debridement

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Changing the bandage


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Procedures

Procedures