No abstract

Split-thickness skin grafting remains a fundamental treatment for patients with deep burns and other traumatic injuries. Unfortunately, the donor site wound that remains after split skin graft (SSG) harvesting may also cause problems for the patient; they can lead to discomfort and scars with a poor cosmetic outcome. Regrafting of the donor site is one of the methods described to improve donor site healing and scarring. In this report, we describe a case of a 26-year-old woman with a self-inflicted chemical burn (0.5% TBSA) who underwent split skin grafting. During surgery, only part of the donor site was regrafted with split skin graft remnants. This part healed faster and had a better scar quality at 3 months postsurgery. Nevertheless, the appearance and patients’ opinion on the regrafted part deteriorated after 12 months. With this case report, we aim to create awareness of the long-term consequences of regrafting, which may differ from short-time results. Patients expected to have poor reepithelialization potential may benefit from regrafting of the SSG on the donor site. But in healthy young individuals, timewise there would be no benefit since it can lead to an aesthetically displeasing result.

There exists little to no data on the development of donor‐site scars that remain after split skin graft harvesting. The objectives of this study were to (a) examine changes in characteristics of donor‐site scar quality over time and (b) assess the agreement between patient‐reported and observer‐reported donor‐site scar quality in a burn population. A prospective cohort study was conducted including patients who underwent split skin grafting for their burn injury. Patients and observers completed the Patient and Observer Scar Assessment Scale (POSAS) for the first harvested donor site at 3 and 12 months post‐surgery. This study included 80 patients with a median age of 34 years. At 3 months post‐surgery, the patients scored the POSAS items itch and color as most deviant from normal skin, both improved between 3 and 12 months (3.1 vs 1.5 and 5.0 vs 3.5, respectively [P < .001]). Other scar characteristics did not show significant change over time. The patients' overall opinion score improved from 3.9 to 3.2 (P < .001). Observers rated the items vascularization and pigmentation most severe, only vascularization improved significantly between both time points. Their overall opinion score decreased from 2.7 to 2.3 (P < .001). The inter‐observer agreement between patients and observers was considered poor (ICC < 0.4) at both time points. Results of current study indicate that observers underestimate the impact of donor‐site scars. This has to be kept in mind while guiding therapy and expectations. LEVEL OF EVIDENCE: II, prospective cohort study.

The aim of this study was to provide insight into the admission rate, treatment, and healthcare costs of patients with fireworks-related burns admitted to a Dutch burn center in the past 10 years. We hypothesized that, like the nationwide number of injuries, the number of patients admitted to a burn center with fireworks-related burn injuries would have decreased during the study period. In this retrospective multicenter cohort study, all patients with fireworks-related burns admitted to a Dutch burn center between 2009 and 2019 were eligible. Patients were identified from a national database and data were obtained regarding admission details, patient and injury characteristics, treatment, and healthcare costs. A total of 133 patients were included. On average, 12 patients were admitted per year. No increase or decrease was observed during the study period. The median total body surface area burned was 1% (P25–P75 0.5–2.5) and 75% of the burns were of partial thickness. Thirteen (10%) patients were admitted to the ICU and 66 (50%) underwent surgical treatment. The mean total healthcare costs across all 133 patients were estimated at €9040 (95% CI €5830 to €12,260) per patient. In contrast to the hypothesis, no increase or decrease was observed in burn center admissions over the past 10 years. Most burns were of small size, but nevertheless, all patients were admitted to a burn center and half of them underwent surgical treatment.