An Official Journal of Polish Society of Orthopaedics and Traumatology
ISSN:1897-2276
e-ISSN: 2449-9145
Introduction. The main problem of contemporary medicine is treatment of patients with deep and large burns. Among them the main group is burned children. Severely burned children are underwent great hazard than adults because of immaturity of tissue structures, imperfection of protection adaptability reactions of organs and systems of organism. Material and methods. Early (on 5-7th days after injury) and early postponed (on 7-9th days after injury) necrectomy with radical excision of injured tissues were performed in 182 children aged from 8th month to 14 years old with burns IIIB-IV grade on the 5-40% of body’s surface. In 37 burned children after surgical necrectomy skin defect was closed using temporary “Foliderm” wound covering. Afterwards final closing of skin defect was performed with perforated autograft at perforation coefficient 1:2. In all patients area of deep burn IIIB-IV grade was differentiated with method of thermometry using dermal thermometer developed in the clinic. Results. The temperature of skin at the area of deep lesions was 1,5-3,0°Ñ, which was lower than undamaged skin. Thus, method of active surgical management by using “Foliderm” synthetic temporary covering and subsequent final closing of deep burn areas with autograft provides reduce of lysis rate of transplanted autografts considerably. Conclusions. Application of combined allo- and autodermoplasty, using of cultivated allofibroblasts in severe burned children with large deep burns and deficit of donor resources permits shorten of restoration term of skin, contributes to favorable outcome of burn disease.
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