Sustainable effect of skin stretching for burn scar excision: Long-term results of a multicenter randomized controlled trial

Verhaegen, Pauline D. H. M.; Wal, Martijn B. A. van der; Bloemen, M.C.T.; Dokter, J.; Melis, Paris; Middelkoop, Esther; Zuijlen, Paul P. M. van

doi:10.1016/j.burns.2011.04.018

Cited by 32 publications

(20 citation statements)

References 25 publications

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“…The subjects included silicone, 1Y7 compression, 8Y11 silicone and compression, 12Y14 topical emollients, 15,16 systemic therapy, 17 intralesional therapy, 18 surgical treatment, 19 and laser. 20 Silicone was the most frequently studied topicVcontaining 7 trials.…”

Section: Study Typementioning

confidence: 99%

The ACAPS and SESPRS Surveys to Identify the Most Influential Innovators and Innovations in Plastic Surgery

Hultman

Friedstat

2014

Annals of Plastic Surgery

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Plastic surgery includes a rich history of both incremental and disruptive innovation, which has endowed our discipline with a competitive advantage over other medical and surgical subspecialties. Based upon our past success in managing change, there may be no limit, or no line on the horizon, as to what is possible, provided that we pursue innovation in a systematic way that combines creativity and discipline.

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Section: Study Typementioning

confidence: 99%

The ACAPS and SESPRS Surveys to Identify the Most Influential Innovators and Innovations in Plastic Surgery

Hultman

Friedstat

2014

Annals of Plastic Surgery

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“…In a clinical setting, the usage of VSD can decrease wound surface and control infection, finally promoting wound healing [2, 8]. In this case, after the first debridement, we used only VSD to treat the wound, and interrupted suturing of the wound was delayed for 3 days.…”

Section: Discussionmentioning

confidence: 99%

The use of a skin-stretching device combined with vacuum sealing drainage for closure of a large skin defect: a case report

Lei

Liu

et al. 2018

J Med Case Reports

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BackgroundThis case report presents the treatment of a large infected skin defect, which was caused by an accidental explosion, through a skin-stretching device combined with vacuum sealing drainage. To the best of our knowledge, the area of the wound that we treated may currently be the largest.Case presentationA 41-year-old Asian man was transferred to the Center of Trauma Surgery of our hospital for the closure of an open infected wound with a large skin defect in his right lower limb caused by an accidental explosion of 100 pieces of blasting cap. The wounds located in his right gluteal were approximately 40 cm × 35 cm. On admission, the wounds had hemorrhaged, exhibiting a darkened appearance, and included scattered metallic foreign bodies. Debridement of his right gluteal area was conducted 6 hours after injury. Subsequently, a skin-stretching device combined with vacuum sealing drainage was applied to reduce the skin defect. This treatment proved to be valuable for the closure of the skin defect and to attain successful functional rehabilitation without sciatic nerve entrapment or amputation in this case.ConclusionsIt is difficult to close large skin defects, especially when they are infected. The application of a skin-stretching device combined with vacuum sealing drainage should be commonly applied to treat infected wounds because it is a safe and easy operative technique.

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“…Color results were expressed as the absolute difference between healthy skin and scar tissue. The objective pliability and color measurements were performed on five locations following a standardized algorithm applied in previous clinical studies . The average score of these five measurements was used.…”

Section: Methodsmentioning

confidence: 99%

Sustainable effectiveness of single‐treatment autologous fat grafting in adherent scars

Jaspers

Brouwer

Trier

et al. 2017

Wound Repair Regeneration

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Following severe injury, not just the skin but also the subcutis may be destroyed. Consequently, the developing scar can become adherent to underlying structures. Reconstruction of the subcutis can be achieved by autologous fat grafting. Our aim was to evaluate the long-term scar outcome after single-treatment autologous fat grafting using a comprehensive scar evaluation protocol. Scar assessment was performed preoperatively in 40 patients. A 12-month follow-up assessment was performed in 36 patients, using the Cutometer, the Patient and Observer Scar Assessment Scale, and DSM II ColorMeter. The Cutometer parameters elasticity and maximal extension improved with 28 and 22% (both p < 0.001), respectively. Nearly all scores of the scar assessment scale decreased significantly, which corresponds to improved scar quality. In addition, the mean melanin score was ameliorated over time. Thus, we demonstrated the sustainable effectiveness of single-treatment autologous fat grafting in adherent scars, indicated by improved pliability, and overall scar quality.Over the last decades, the treatment of severely burned patients has improved considerably. However, scarring remains a significant challenge. Scars are not only apparent after burns, but also after other severe injuries such as necrotizing fasciitis or degloving. Injuries severe enough to affect the subcutis destroy the important functional sliding layer between the resulting scar and underlying structures (i.e., muscles, tendons, bone tissue). This ultimately leads to stiff and adherent scars that may limit the affected body part's range of motion.1 In this case, the only available option to partially reconstruct the subcutis is autologous fat grafting, whereby several layers of fat are injected to generate a sliding system between the scar and the underlying structures.Recently, we demonstrated the short-term effectiveness (i.e., 3 months follow-up) of single-treatment autologous fat grafting in adherent scars using a comprehensive scar evaluation protocol.2 Here, we report on the long-term scar outcomes (i.e., 12 months postoperatively) of autologous fat grafting. To our knowledge, this is the first large case-series that provides these data in this rapidly developing field. MATERIALS AND METHODS Study design and patientsA prospective study with intraindividual follow-up was performed in 40 consecutive adult patients with adherent scars caused by either burns, necrotizing fasciitis, degloving injury, or other trauma. Scar evaluation was performed within 24 hours preoperatively and at 12 months postoperatively. A concise description of the scar evaluation protocol, fat grafting procedure, and statistics is provided below. More detailed information can be found in our publication on the short-term results.

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Sustainable effect of skin stretching for burn scar excision: Long-term results of a multicenter randomized controlled trial

Cited by 32 publications

References 25 publications

The ACAPS and SESPRS Surveys to Identify the Most Influential Innovators and Innovations in Plastic Surgery

The ACAPS and SESPRS Surveys to Identify the Most Influential Innovators and Innovations in Plastic Surgery

The use of a skin-stretching device combined with vacuum sealing drainage for closure of a large skin defect: a case report

Sustainable effectiveness of single‐treatment autologous fat grafting in adherent scars

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