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- Title
Factors that Affected Functional Outcome After a Delayed Excision and Split-Thickness Skin Graft on the Dorsal Side of Burned Hands.
- Authors
Ryuji Shichinohe; Yuhei Yamamoto; Kunihiro Kawashima; Chu Kimura; Kentaro Ono; Katsumi Horiuchi; Tetsunori Yoshida; Naoki Murao; Toshihiko Hayashi; Emi Funayama; Akihiko Oyama; Hiroshi Furukawa; Shichinohe, Ryuji; Yuhei, Yamamoto; Kawashima, Kunihiro; Kimura, Chu; Ono, Kentaro; Horiuchi, Katsumi; Yoshida, Tetsunori; Murao, Naoki
- Abstract
Early excision and skin grafting is the principle treatment for a burned hand although there are occasions when it cannot be done such as severe general condition, delayed consultation, and the lack of a definitive assessment of burn depth. This study analyzes the factors that affected function after a delayed excision and skin graft for hands with a deep dermal burn. This study retrospectively evaluated 43 burned hands that required a delayed excision and split-thickness skin graft on the dorsal side. Cases were required to only have split-thickness skin grafting from the dorsum of the hand and fingers distally to at least the proximal interphalangeal joint at least 8 days after the injury. The hands were divided into two functional categories: Functional category A, normal or nearly normal joint movements, and functional category B, abnormal joint movements. Demographic data were assessed statistically by a univariate analysis following a multiple regression analysis by a stepwise selection. A significant difference was observed between the groups in the number of days from grafting to complete wound healing of the graft site and with or without an escharotomy in the analysis. These parameters were statistically significant predictors of functional category B. The functional outcome of a burned hand after a delayed excision and split-thickness skin graft on the dorsal side became degraded depending on the number of days from grafting to complete wound healing. Cases that underwent an escharotomy also showed deterioration in function.
- Subjects
TREATMENT for burns &; scalds; BURNS &; scalds; GRAFT versus host reaction; HAND injuries; SKIN grafting; WOUND healing; TREATMENT effectiveness; SEVERITY of illness index
- Publication
Journal of Burn Care & Research, 2017, Vol 38, Issue 5, pe851
- ISSN
1559-047X
- Publication type
journal article
- DOI
10.1097/BCR.0000000000000505