Correction of Postburn Neck Scar Contracture Using Thick Split Thickness Skin Graft

Hypertrophic scar contracture is an unfavorable and critical phenomenon in deep second or more serious degree burn patients, particularly when these hypertrophic scar contractures involve face, neck, upper extremities, lower extremities and perineal area. In the neck, preservation of contour of cervicomental angle and good range of motion is important in deeply burned patients. Traditionally cutaneous free flap or full thickness skin graft were used to restore this skin defects after release of scar contracture. Using one large piece of thick skin graft for covering the defect of neck is important key point. We applied thick split thickness skin graft instead of full thickness skin graft or free flap treating these patients who had hypertrophic scar contracture of neck. We experienced 12 patients of hypertrophic scar contracture of neck treated with thick split thickness skin graft of 30/1,000 inch in thickness. All patient were followed up for one year and evaluated for ROM(Range of motion) by means of A.M.A.(American Medical Association) method. All patients restored the ROM near to normal after one year. In conclusion, thick split thickness skin graft can be easily harvested from thick thigh and allows patients to restore good range of motion of neck and contour.

Treatment of Penile Vaselinoma Using Thick Split Thickness Skin Graft

The problems of foreign body injection such as vaseline, paraffine, mineral oil for penile augmentation done by illegal medical practitioners are tissue inflammation, necrosis, granuloma formation, deformity and erectile dysfunction. The treatment of these complication are composed of foreign body removal and resurfacing of denuded penis. Many resurfacing procedures are introduced such as split thickness skin graft, flap-to-graft conversion method, scrotal flap, groin flap and free flap. Skin graft is the simplest method with minimal donor site morbidity, but there are some complications like scar contracture, hypertrophic scar and difficulty of erection. Thick split thickness skin graft can prevent these complications. We measured the length, circumference and surveyed erectile function with International Index of Erectile Function(IIEF) after long-term follow up. Increase in mean length and circumference at erection are 43% and 36%, respectively, compared to resting, and the survey with IIEF had a better result than that of normal control group. We found preserved erectile function without scar contracture and hypertrophic scar. Thick split thickness skin graft is the good method for treatment of penile vaselinoma with simplicity, minor donor site morbidity and preservation of erectile function.