title: Is there any place for spontaneous healing in deep palmar burn of the child?
abstract: Child palm burns arise by contact and are often deep. The singular difficulty of such a disease comes from the necessity of the child growth and from the potential occurrence of constricted scars. In order to avoid sequelae, the actual gold standard is to practice an early excision of the burn, followed by a skin graft. The aim of this study is to evaluate the results of spontaneous healing combined with rehabilitation versus early skin grafting and rehabilitation concerning the apparition of sequelae. We performed a retrospective study in two burn centers and one rehabilitation hospital between 1995 and 2010. Eighty-seven hands have been included in two groups: one group for spontaneous healing and the other group for excision and skin grafting. Every child benefited from a specific rehabilitation protocol. The two main evaluation criteria were the duration of permanent splint wearing and the number of reconstructive surgery for each child. The median follow-up duration is about four years. The two groups were comparable. For the early skin grafting group, the splint wearing duration was 1/3 longer than for the spontaneous healing group. Concerning the reconstructive surgery, half of the grafted hands needed at least one procedure versus 1/5 of spontaneous healing hands. Our results show the interest of spontaneous healing in palmar burn in child, this observation requires a specific and intense rehabilitation protocol.
authors: Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69004 Lyon, France. Electronic address: joseph.chateau1@gmail.com.
authors: J
authors: J
authors: Chateau
authors: Centre de rééducation pédiatrique Romans-Ferrari, 01700 Miribel, France.
authors: M
authors: M
authors: Guillot
authors: Centre de rééducation pédiatrique Romans-Ferrari, 01700 Miribel, France.
authors: L
authors: L
authors: Zevounou
authors: Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69004 Lyon, France.
authors: F
authors: F
authors: Braye
authors: Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Saint-Joseph-Saint-Luc, 69007 Lyon, France.
authors: J-L
authors: JL
authors: Foyatier
authors: Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Saint-Joseph-Saint-Luc, 69007 Lyon, France.
authors: J-P
authors: JP
authors: Comparin
authors: Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Saint-Joseph-Saint-Luc, 69007 Lyon, France.
authors: D
authors: D
authors: Voulliaume
mesh_terms: D002053:Burn Units; D002056:Burns / Q000601:surgery / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003646:Debridement / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006230:Hand Injuries / Q000534:rehabilitation / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods; D013165:Splints; D013526:Surgical Mesh; D016896:Treatment Outcome; D014945:Wound Healing
keywords: Brûlures palmaires; Cicatrisation dirigée; Palmar burn; Pediatric plastic surgery; Plastique pédiatrique; Spontaneous healing