Direct tissue expansion in surgical treatment of burns and burn after math for children

Abstract

Introduction. Surgical treatment, of burns and deformed scars on children, is required even after many years after the trauma, often during the whole growth period of the child. Reconstruction of the profound tissue defects (disclosure of the cranial bones, joints, functional structures of the extremities) presents serious difficulties. The reconstruction method through direct tissue expansion of the intact tissues, bordering with the defected one, allowed coverage with functional tissue, which proved its efficiency in treatment of burns and their aftermath. Materials and methods. During the past 15 years (2002-2017) in the Department of Burns and Plastic surgery, there were treated 58 patients (7-18 years old) with the method of direct tissue expansion: 1.Profound thermal burns – 8 2.Electric burns – 10 3.Post burn alopecia – 32 4.Scar deformations of head and neck - 6 5.Scar deformations of the extremities – 2 Results. With 41 patients were obtained good results; with 14 – satisfactory. Complications in post-surgical period developed with 3 patients (in 2 cases – marginal necrosis of the flap, in 1 – infection of the cavity and as a result - necessity to remove the expander). The developed complications were resolved with the help of other reconstructive methods. Conclusions. In the reconstruction surgery of burns and their consequences, direct tissue expansion has a particular place with certain indications: 1.The need of donor tissue of certain quality (color, elasticity, hairy tissue). 2.Intact plastic material (skin, fatty tissue, fascia). 3.Aesthetic efficiency of the plastic material.