Wan-SzePek*, Janna-Vale Joethy and Si-Jack Chong
Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, SingaporeFulltext PDF
There is a paucity of data on the use of dermal substitutes in a tropical burns centre, as its use was previously complicated by a high infection rate in the Southeast Asian region, further hindered by high costs. We hence describe our successful experience with a bi-layered artificial dermis (PelnacTM) and thin split-thickness skin graft (STSG) in treating post-burns hypertrophic scars and contractures when a lack of donor sites precluded reconstruction with traditional locoregional flaps. A two-staged procedure comprising artificial dermis and STSG was used to reconstruct full thickness wounds after excision of burns contractures over 11 sites (5 patients) - three wrists, three necks, two ankles, one elbow, one chin, and one ear auricle. Time to skin grafting was 18.4 days, with a 100% STSG take. One wound (9%) developed hypertrophic scarring around its border but the rest healed with a pliable consistency and satisfactory cosmetic outcome. Full range of motion was restored in treated scars located over joints. No infective complications were encountered. We demonstrate that a bi-layered artificial dermis with STSG may be used reliably in a tropical burns centre with no infective complications, whereby a consistent technique contributes greatly to its success.
Burn contracture; Artificial dermis, Scar, Reconstruction
Wan-SzePek, Joethy J-V, Chong S-J. Caveats and Technique for the Reconstruction of Burn Contractures Using an Artificial Dermis in a Tropical Burns Centre. Clin Surg. 2017; 2: 1674.