Rigottotomy and lipofilling in the treatment of post-burn deformations in children: our experience

Abstract

Actuality: rigottotomy and lipofillingis a method of surgical correction of post-burn deformities and scars. Rigottotomy increases the area of the reconstructed segment, which in the future, when performing lipofilling, allows to restore the contours and volume. The purpose of the study: evaluation of the advantages of this method compared to classical surgical operations. Patients and methods: we evaluated the results of treatment of 25 children with post-traumatic deformities and post burn scars and deformities of various localization. The stages of surgical correction: the first stage - the actual liposuction (tumescent). The second stage (primary) - preparing a donor bed to transplant fat cells. Implementation of rigottotomy (formation of channels crossing the scarred tissue in different planes) which are filled with lipoaspirates.The third stage – subcutaneous and/ or intradermal injection oflipografts to fill the volume with contour deformities. Patients divided into groups: the first group is about 10 children with a contoured deformation (post-burn and post-traumatic). The treatment was performed in several stages (at least 3). The first step is to fill no more than 20-30% of the area of the defect. For surgical correction of patients of this group were mainly used fat grafting. The second group of 9 children with hypertrophic scars and contractures of large joints. First stage is aggressive rigottotomy and subsequent intradermal injection of litografts to correct contractures. The third group is a group of 6 children with post-burn scars, violations of the structural composition of the skin. All patients have necessitated the 1-2 stages of lipofilling in combination with rigottotomy that helped to improve the quality of the skin and partly to eliminate cosmetic defect. All patients have received a good cosmetic and functional result. There were not any complications. Conclusion: advantages of this technique are: reducing the time of hospitalization; elimination of cosmetic defects and deformities; formation and recovery of the subcutaneous fat layer; improve the elasticity of the skin.