title: Recalcitrant caustic burn wound and definitive treatment with medial plantar flap.
abstract: Caustic chemicals cause destruction in tissues even long after the initial exposure. This study reported a case of recurrent graft lysis encountered throughout the treatment of a sodium hydroxide burn. A caustic burn on the ankle of a patient was reconstructed with split thickness skin grafts thrice in a period of four months. The burn site healed uneventfully after each skin grafting. However, weeks after each successful graft take, even though the patient did not experience any trauma at his operated ankle, an eczematous blistering at the skin graft site was observed. Thereafter, skin grafts almost totally sloughed over time even after each successful graft take. Six months after the initial burn and recurrent skin graft lysis, the defect site was reconstructed with medial plantar flap. At the postoperative ninth month follow-up, there was no sign of the blistering or skin loss at the burn area after definitive flap surgery. Recurrent graft lysis, in a few weeks after total skin graft take is an unusual complication for most of the burn cases. Caustic burns may have a deceptively superficial appearance concealing the chemical reactions that further damage the tissue. Therefore, early surgical interventions such as deep debridement and graft surgery should be kept in mind as primary treatment options.
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, Burn Unit, GATA Haydarpasa Training Hospital, Istanbul, Turkey.
authors.forename: Sinan
authors.initials: S
authors.lastname: Öksüz
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, Burn Unit, GATA Haydarpasa Training Hospital, Istanbul, Turkey.
authors.forename: Fikret
authors.initials: F
authors.lastname: Eren
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, Burn Unit, GATA Haydarpasa Training Hospital, Istanbul, Turkey.
authors.forename: Celalettin
authors.initials: C
authors.lastname: Sever
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, Burn Unit, GATA Haydarpasa Training Hospital, Istanbul, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Karagöz
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, Burn Unit, GATA Haydarpasa Training Hospital, Istanbul, Turkey.
authors.forename: Ersin
authors.initials: E
authors.lastname: Ülkür
mesh_terms: D000842:Ankle; D002057:Burns, Chemical / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002424:Caustics / Q000009:adverse effects; D003646:Debridement; D006084:Graft Rejection; D006801:Humans; D008297:Male; D016038:Skin Transplantation; D012972:Sodium Hydroxide / Q000009:adverse effects; D013524:Surgical Flaps; D014945:Wound Healing; D055815:Young Adult
chemical_list: D002424:Caustics; D012972:Sodium Hydroxide