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Dermal regeneration template for deep hand burns: clinical utility for both early grafting and reconstructive surgery  E Dantzer, P Queruel, L Salinier,

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Presentation on theme: "Dermal regeneration template for deep hand burns: clinical utility for both early grafting and reconstructive surgery  E Dantzer, P Queruel, L Salinier,"— Presentation transcript:

1 Dermal regeneration template for deep hand burns: clinical utility for both early grafting and reconstructive surgery  E Dantzer, P Queruel, L Salinier, B Palmier, J.F Quinot  British Journal of Plastic Surgery  Volume 56, Issue 8, Pages (December 2003) DOI: /S (03)

2 Fig. 1 A 51-year-old male with acute burn injuries to the left hand: (a) preoperative view, (b) perioperative view on day 3 after grafting of 250 cm2 of the dermal regeneration template, (c) cosmetic results at 1 year, and (d) functional results at 1 year. British Journal of Plastic Surgery  , DOI: ( /S (03) )

3 Fig. 2 A 29-year-old male with acute burn injuries to the left palm: (a) preoperative view, (b) result at 18 months after surgery showing that skin at healed site was supple and that there was no adherence to deeper layers, (c) excellent functional recovery with normal finger extension and normal thumb opposition, and (d) complete finger flexion. British Journal of Plastic Surgery  , DOI: ( /S (03) )

4 Fig. 3 A 58-year-old male with acute injury to the left hand: (a) preoperative view showing severe 3rd-degree burns that required the finger extremities be amputated but allowed treatment plan to salvage remainder of fingers, and (b) Integra dermal regeneration template grafted directly over the exposed bones on the dorsal surface of the fingers 3 weeks after excision of fingertips. A 100% successful graft was achieved with excellent functional outcome at 9 months, as evidenced by capability for (c) finger extension, (d) finger flexion, (e) grip and (f) flexion of the proximal phalanx of the index finger. British Journal of Plastic Surgery  , DOI: ( /S (03) )

5 Fig. 4 A 39-year-old male with bilateral hypertrophic scars of the dorsum, thumb columns and forearms requiring reconstructive surgery: (a) preoperative view of hypertrophic and retractile scars on the lower arm extending to the thumb column, (b) neovascularised dermal regeneration template on day 17 with the silicone layer removed prior to epidermal autograft placement, (c) ultrathin epidermal autograft placed on day 17 after harvesting from the arm, (d) final cosmetic results of left hand at 15 months postoperatively with normal skin colour and absence of hypertrophic scars, (e) normal skin pliancy with no adherences to deep planes, and (f) thumb opposition and normal flexibility; on the contralateral hand (not shown) similarly favourable results were evident. British Journal of Plastic Surgery  , DOI: ( /S (03) )

6 Fig. 5 A 58-year-old female with adherent grafts on the forearm and dorsal hand resulting from use of expanded grafts after initial injury: (a) perioperative view of excision of primary grafts until total functional freedom of hand had been restored, (b) final cosmetic result at 10 months follow-up, (c) finger flexion at 10 months, (d) normal range of motion with no adherences between the skin and deep planes after grafting of dermal regeneration template over tendons. British Journal of Plastic Surgery  , DOI: ( /S (03) )

7 Fig. 6 A 45-year-old male with palmar and wrist scarring involving neurovascular compression of the median and ulnar nerves: (a) preoperative view of carpal and Guyon's tunnel freed from scar compression, (b) normal range of motion postoperatively, (c) normal flexion of fingers, and (d) normal opposition of thumb. British Journal of Plastic Surgery  , DOI: ( /S (03) )


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