Autologous Scar-Related Tissue Combined with Skin Grafting for Reconstructing Large Area Burn Scar

Abstract

Background

This study introduced a novel method to reconstruct large areas of scarring caused by burns via combining autologous scar-related tissue with spit-thickness skin grafting (ASTCS).

Methods

25 patients underwent reconstruction after scar resection surgeries around the joints were analyzed between Jan 2012 and Jan 2018. Patient demographics and clinical parameters were collected, autologous scar-related tissue was modified to meshed structure, and the split-thickness skin was acquired from the scalp. The scar was resected and punched by a meshing machine with a thickness of 0.3–0.5 mm at a ratio of 1:1. The secondary wounds were covered by the epidermis from a donor site. The surgical areas were bandaged for 7–10 days before the first dressing change.

Results

25 patients (mean [SD] age, 26.4 [18.8] years; 16 [64%] men) underwent wounds reconstructive operations due to scar resection were reviewed. Wound location of 9 (22%), 8 (19.5%), 9 (22%), 7 (17.1%) and 8 (19.5%) cases were reconstructed in axillary, hand and wrist, popliteal fossa, elbow and neck, respectively. 39 sites of transplanted tissues survived well, and 2 sites were cured after two weeks of dressing changes. Except the analysis of injury causes, nutritional status, wound area and hospital days, patients with scar deformities in joint areas achieved satisfactory function by assessing the Vancouver Burn Skin Score and the Barthel Index Scale Scores after 12-month follow-up.

Conclusions

Combining autologous scar-related tissue with skin grafting provided a novel method for treating large areas of burn scars with better functional outcomes.

Keywords:

• Plastic surgery
• surgical technique
• tissue engineering
• trauma
• wound healing
• transplantation

View addendum:

Tackling Large Area Burn with Combinational Tissue Grafting

Disclosure statement

The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.

Author contribution

Juntao Han designed the operation and acted as operator. Zhuoqun Fang, Jun Li and Kejia Wang worked as assistants in the operation. Zhuoqun Fang, Jun Li and Kejia Wang collected all the information and written contents from the patients. Jun Li and Xuekang Yang performed the statistical analysis. Hongtao Wang and Songtao Xie contributed to the pathological analysis. Juntao Han revised the manuscript and approved the final submission. All authors discussed the results and reviewed the manuscript. All of the protocols were approved by the Ethics Committee of Xijing Hospital, affiliated with Air Force Medical University (China).