In the process of surgical treatment of deep burns 65 children managed to close the wound simultaneously (the area of damage to 10-12), 33rd others had to repeat the operation up to 2-3 times (in 98 patients — 172 operations).
Here we observed, in addition to severe General condition, extensive burn wounds. Five patients had to be re-fence the skin from the same area (the shortage of donor area). Complications were not observed.
The wound after the plastic is forced to the closed method, due to functional immaturity of our patients (age, impossibility of adequate reactions, mobility, etc.).
Mortality tends to decrease and as follows from 138 annealed children in 1983, died on 11 (7,2), operated on 22 patients (died two). In 1984, 143 annealed died, 7 (4,5) patients 38 (died 1). In 1985, 168 annealed died 4 (2,1) also operated a 38 — dead not.
All of the above was the reason for revision surgical tactics, and now we practice mesh transplant grafts (89 patients) and one-piece, non-perforated (81 patients). Two patients used a plastic Mowlem — Jackson.
In our opinion, under certain conditions, both methods give quite effectively in the treatment of deep burn wounds. Of course, in cosmetic terms, more attention should be non-perforated flap. A disincentive to the wider implementation of the method is the potential exclusion of the flap wound content (in the analyzed group of patients complications we have not met).
In this respect it is more appropriate the use of mesh graft (flap perforatum standard punch or scalpel) that allows you to close a large cross-sectional area of the lesion the transplant more freely simulates the surface of a wound better fixed to the bottom and the edges of the wound.
While acknowledging the positive and shadow qualities of both methods, we believe that the choice of method of surgical treatment should be determined by the size of the wound, its interested to functional areas of the patient’s condition, requirements, cosmetics, etc.
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