Skin Healing of Deep Second Degree Burn Injuries in Four Individuals Sustained in a Boat Explosion—Results after Different Approaches

Vincent März,Peter M Vogt

doi:10.3390/ejbc1010003

Abstract

Intermediate and deep second-degree skin burn injuries are an ongoing challenge for burn surgeons, with the difficult decision regarding whether to handle them with either conservative or operative methods. In this study, the outcome of similar deep second-degree skin burn injuries is shown with the example of four family members. Clinical outcomes of the four family members which were treated at our burn center in 2017 were analyzed. The areas of burned skin (IIa°-IIb°) extended from 14% to 38% of the total burned skin area. Surgical treatment was adjusted to the rate of epithelialization after the first debridement. The excellent cosmetic long-term results of this patient cohort support the importance of stage-related therapy of deep dermal burn injuries. An initial debridement followed by early coverage is the key to early reconstitution of the epidermal barrier. However, with regard to the late effects of skin substitutes, more sensory alterations, dysesthesia, hyperpigmentation and unstable skin areas are still visible after coverage with glycerol conserved skin. The best results were seen after the use of autologous STGS and synthetic skin.

Highlights

Intermediate and deep second-degree skin burn injuries are an ongoing challenge for burn surgeons, with the difficult decision regarding whether to handle them with either conservative or operative methods
The outcome of similar deep second-degree skin burn injuries is shown with the example of four family members
Clinical outcomes of the four family members which were treated at our burn center in 2017 were analyzed

Summary

Introduction

Intermediate and deep second-degree skin burn injuries are a challenge for burn surgeons, with the difficult decision as to whether had to handle them with either conservative or operative methods. Options range from stimulated spontaneous healing up to aggressive surgical debridement and grafting. In this naturally occurring randomized prospective study, the outcome of similar deep second-degree skin burn injuries is shown in the example of four family members. All of them (father 50 yrs, mother 39 yrs, boy 11 yrs and girl 8 yrs) were exposed to the flames of an exploding boat engine in summer 2017 and demonstrated homogenous patterns of burn injuries. The girl, the boy and the mother were relocated by plane to our burn center at the Medical School Hannover.

Materials and Methods

Findings

Conclusions