A retrospective analysis of securing autologous split-thickness skin grafts with negative pressure wound therapy in paediatric burn patients.
OBJECTIVE
Deep dermal and full-thickness burn wounds are excised and grafted with split-thickness skin grafts. Especially in less compliant patients such as young children, conventional fixing methods can often be ineffective due to high mobility rates in this age group. The aim of this retrospective single-centre study was to give an overview of our experience in the fixation of autologous split-thickness skin grafts (ASTSGs) on burn wounds by negative pressure wound therapy (NPWT) in paediatric patients.


METHODS
A retrospective analysis describing 53 paediatric patients with burns or burn-related injuries who were treated as 60 individual cases were conducted. All patients received ASTSGs secured by NPWT.


RESULTS
Of the individual cases, 60 cases with a mean age of 8±6 years (the youngest was 3 months, the eldest was 24 years old) were treated in a single procedure with ASTSG and NPWT. Total burn surface area (TBSA) was, median (med) 4.5% (3.0-12.0%). The TBSA of deep dermal thickness to full-thickness (IIb-III°) burns was med 4.0% (2.0-6.0%). The TBSA treated with ASTSG and NPWT was med 3.5% (2.0-6.0%). Take rate was, med 96% (90-99%) with a total range of 70-100%. The only significant correlation that could be found was between the grafted TBSA and the take rate. The smaller the grafted TBSA the better the take rate resulted, as expected. In three cases, major complications were noted.


CONCLUSIONS
To sum up our experience, the NPWT system has developed itself to be a constant, well-implemented and useful tool in securing ASTSGs to the wound bed. The main advantage of the technique is a much higher mobility of the patient compared to conventional fixation methods. The high compliance rate of an often challenging group of patients such as children recompenses possible higher costs compared to conventional fixation methods.
Children's Burn Unit, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria. Electronic address: michael.hoeller@klinikum-graz.at.
Michael
M
Hoeller
Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
Michael Valentin
MV
Schintler
Children's Burn Unit, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
Klaus
K
Pfurtscheller
Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
Lars-Peter
LP
Kamolz
Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Norbert
N
Tripolt
Children's Burn Unit, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
Marija
M
Trop
D000293:Adolescent; D000328:Adult; D001458:Bandages; D002056:Burns / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D008297:Male; D054843:Negative-Pressure Wound Therapy; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D014182:Transplantation, Autologous; D014945:Wound Healing; D055815:Young Adult
Autologous split-thickness skin graft; Mobility; Negative pressure wound therapy; Treatment of paediatric burns