title: Forty-Year Follow-up of Full-Thickness Skin Graft After Thermal Burn Injury to the Volar Hand.
abstract: BACKGROUND
  The hands are commonly affected in severe thermal burn injuries. Resulting contractures lead to significant loss of function. Burn contracture release and skin grafting are necessary to restore hand function. We report a case in which surgical reconstruction of a volar hand burn was performed with full-thickness skin grafting. The patient had a 40-year follow-up to assess the function and cosmesis of the repaired hand.
  
  
  METHODS
  We report a case in which a 15-month-old boy presented after receiving third-degree burns to the left volar hand, including the flexural aspects of the index, long, and ring fingers by placing it on a hot kitchen stove burner. The patient subsequently underwent scar contracture release and full-thickness skin grafting.
  
  
  RESULTS
  Eleven years after reconstruction, further contractures developed associated with the patient's growth, which were reconstructed with repeat full-thickness skin graft from the inguinal region. No recurrence was witnessed afterward and 40 years after initial injury, the patient maintains full activities of daily living and use of his hand in his occupation.
  
  
  CONCLUSIONS
  There is debate regarding the superiority of split-thickness versus full-thickness grafts during reconstruction. Our case strengthens the argument for durability of a full-thickness skin graft following thermal burn injury.
authors.affiliation: University of Louisville School of Medicine, Louisville, Ky.
authors.forename: Dexter
authors.initials: D
authors.lastname: Weeks
authors.affiliation: Robley Rex Veterans Affairs Medical Center, Louisville, Ky.
authors.forename: Morton L
authors.initials: ML
authors.lastname: Kasdan
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of Louisville, Louisville, Ky.
authors.forename: Bradon J
authors.initials: BJ
authors.lastname: Wilhelmi
keywords: burn injury reconstruction; burn reconstruction; full-thickness skin graft; thermal burn injury; volar hand burn