Application of meshed acellular allogeneic dermal matrix and split thickness autogenous skin graft for the treatment of pediatric claw hand / 中华整形外科杂志

ABSTRACT

Objective@#To explore the methods and the clinical effect of composite skin graft with meshed acellular allogeneic dermal matrix(allo-ADM)and split thickness autogenous skin graft for pediatric claw hand.@*Methods@#From January 2013 to March 2016, acellular allogeneic dermis matrix(allo-ADM)with split thickness autogenous skin graft was applied for 13 cases(20 hands) of burned pediatric claw hands. The size of the wounds ranged from 6cmx6cm to 10cmx17cm, located in the back of the proximal phalanx and hand. The scar was totally excised and hands′deformities were corrected, with allo-ADM and split thickness autogenous skin graft to cover the wounds. Kirschner wire and plaster fixation, graft gauze bag pile were released 2 weeks after surgery, following by wearing a brace and elastic glove for rehabilitative therapy.@*Results@#2 weeks after transplantation the composite skin survival rate was 70%-100%; 10 cases(17 hands) were followed up for 10 months to2 years. The skin graft survival rate was 70% in 2 cases(3 hands), who underwent secondary operation to correct deformity. The composite skin graft survival rate was above 90% in 8 cases(14 hands). Long term follow-up results showed that composite skin graft had satisfactory elasticity and color. According to the active range assessment of joint movement (TAM method), the results were excellent (TAM% equals to 100%) in 4 hands, good (TAM% was greater than 75%) in 11 hands and acceptable (TAM% was equal to 50%) in 2 hands.@*Conclusions@#Composite transplantation of acellular allogeneic dermis matrix with spit thick autogenous skin graft can effectively improve the appearance and function of children′s claw hand, while avoiding the scar formation due to the harvest of full thickness skin.