title: Algorithm for Primary Full-thickness Skin Grafting in Pediatric Hand Burns.
abstract: BACKGROUND
  Pediatric hand burns are a difficult problem because they lead to serious hand deformities with functional impairment due to rapid growth during childhood. Therefore, adequate management is required beginning in the acute stage. Our study aims to establish surgical guidelines for a primary full-thickness skin graft (FTSG) in pediatric hand burns, based on long-term observation periods and existing studies.
  
  
  METHODS
  From January 2000 to May 2011, 210 patients underwent primary FTSG. We retrospectively studied the clinical course and treatment outcomes based on the patients' medical records. The patients' demographics, age, sex, injury site of the fingers, presence of web space involvement, the incidence of postoperative late deformities, and the duration of revision were critically analyzed.
  
  
  RESULTS
  The mean age of the patients was 24.4 months (range, 8 to 94 months), consisting of 141 males and 69 females. The overall observation period was 6.9 years (range, 1 to 11 years) on average. At the time of the burn, 56 cases were to a single finger, 73 to two fingers, 45 to three fingers, and 22 to more than three. Among these cases, 70 were burns that included a web space (33.3%). During the observation, 25 cases underwent corrective operations with an average period of 40.6 months.
  
  
  CONCLUSIONS
  In the volar area, primary full-thickness skin grafting can be a good indication for an isolated injured finger, excluding the web spaces, and injuries of less than three fingers including the web spaces. Also, in the dorsal area, full-thickness skin grafting can be a good indication. However, if the donor site is insufficient and the wound is large, split-thickness skin grafting can be considered.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Yang Seo
authors.initials: YS
authors.lastname: Park
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Lee
authors.forename: Gi Yeun
authors.initials: GY
authors.lastname: Huh
authors.forename: Jang Hyu
authors.initials: JH
authors.lastname: Koh
authors.forename: Dong Kook
authors.initials: DK
authors.lastname: Seo
authors.forename: Jai Koo
authors.initials: JK
authors.lastname: Choi
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Jang
keywords: Burns; Child, preschool; Skin transplantation