Treatment of massive skin avulsion of limbs with ultrathin flaps and full-thickness skin grafts

Abstract

Objective To discuss the treatment of massive skin avulsion of limbs with ultrathin flaps and fuU-thickness skin grafts. Methods Twenty-one patients with massive skin avulsion of limbs were included in this study.In this group,the area of skin avulsion occupied 2%to 6%of the total body surface. Averaging 3.3%.According to the characteristics and conditions of their wound surfaces.the avulsed skin Wma divided into absolute ischemic zone,partial ischemic zone and abnormal zone.The 3 zones were shaped into a graft complex composed of full-thickness skin zone,junctional zone and ultmthin flap zone respectively.The graft complex was transplanted onto the wound surface.Results In all the patients.90%to 100%of the avulsed skin survived.with an average of 94.1%.There wag no infection.In the 12 cases that had bee followed up for 2 months t0 3 years,the grafted skin showed normal shape,color,texture,sensstion,and function. Conclusions Since the graft complex effectively combines the advantages of both full-thickness flaps and ultmthin flaps and maintains the maximum morphology of the avulsed skin as well.it can improve the survival of avulsed skin.Moreover,the operation is easy and safe. Key words: Avulsion of skin; Flap; Complex; Graft