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Volume 7, Issue 3 (Suppl)
Otolaryngol (Sunnyvale), an open access journal
ISSN:2161-119X
Head, Neck and Plastic Surgery 2017
June 19-20, 2017
June 19-20, 2017 Philadelphia, USA
5
th
Global Summit and Expo on
Head, Neck and Plastic Surgery
Application of skin stretching technique for closure of large surface skin defects in children
Mariya Shcherbakova, Trusov A, Rybchenok V, Fomina M, Starostin O, Tsapkin A
and
Lagutina A
Speransky Children's Hospital, Russia
Introduction & Aim:
Large surface skin defect closure after extensive burn trauma remains an important issue in plastic and
regenerative surgery. Deficit of intact skin dictates a careful and creative approach to donor skin surfaces. Skin stretching
technique using endo expansion device is a promising approach to treat large skin defects. It allows a significant reduction of
scar surface area. Application of this technique for free dermal transplants allows receiving skin grafts similar to normal skin.
The goal of this approach is to form a full-thickness skin flap of a desired size in cases where traditional skin donor surface areas
are limited or not available. The resulting skin flap could be used on various body parts. The purpose of the study is to further
characterize and advance the method of skin surface expansion for auto-grafting.
Materials &Methods:
25 patients aged 4 to 17 years with large-surface skin defects were treated using skin stretching technique.
24 patients had burn trauma and one patient had a trauma related to a car accident. All patients had scar deformations and
various degrees of contractures, which were associated with significant limitations in their everyday life. Either large (120×45
mm) or small (90×45 mm) skin stretching devices were placed endoscopically. Radio knife ‘Surgitron’ and hydro knife
‘Versa jet’ were used for incisions. Skin stretching was achieved by gradual expansion of latex ballooning devices using 0.9%
normal saline over a period of 4-8 weeks. Various body areas were used as a donor site for skin stretching based on individual
cases - back, lateral chest and abdomen. Four patients received local intra dermal injections of botulinum toxin at the site of
implantation of skin expansion device 3-4 days prior to the procedure.
Results:
Using skin stretching devices, we were able to get full-thickness donor skin surfaces ranging from60 square centimeters
to 300 square centimeters. Wounds were closed using adjacent skin tissue. Small linear normotrophic scars were formed as a
result. Four patients had some degree of peripheral necrosis at the edges, which were successfully treated using conservative
methods. Scar deformations and contractures were corrected in all patients. Recipients of botulinum toxin-treated skin grafts
seem to do better during recovery period likely due to improved skin elasticity.
Conclusions:
Skin stretching technique has been proven to be a useful method in managing large surface skin defects in
pediatric patients with various burn trauma, scar contractures, other traumatic causes of skin defects. Skin stretching technique
allows receiving a full-thickness auto skin graft of a desired size similar to normal skin. This method solves a problem with lack
of skin auto-graft for closure of large surface wound areas. Intradermal injections of botulinum toxin seem to increase elasticity
of the expanded skin graft.
Biography
Mariya Shcherbakova was graduated from I.M. Sechenov First Moscow State Medical University in 2013. She has completed her Pediatric Surgery Residency in
2016 and joined staff of Speranskiy Children’s Hospital in Moscow, Russia in 2016 as a Pediatric Surgeon and as a Staff Scientist. Her special interests include
plastic and reconstructive surgery in children, treatment of children with post-traumatic and burn injuries, etc.
childsurg.maria@yandex.ruMariya Shcherbakova, Otolaryngol (Sunnyvale) 2017, 7:3 (Suppl)
DOI: 10.4172/2161-119X-C1-016