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Pediatric Hand Burn Reconstruction: Timing and Technique
P. Warner, MD, B. Starr, MD, C. Y. Villamaria, MD, C. Schwanholt, BS, K. P. Yakuboff, MD
University
2018-02-01
Presenter: Carole Villamaria
Affidavit:
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Director Name: Ann Schwentker, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
Introduction: Pediatric burn injury to the hand can lead to significant functional exacerbated by sequelae of scar contractures due to growth. The number and types of reconstructive procedures required to maintain hand function vary depending on the age of injury and extent of involvement. The goal of this study was to review all hand burns requiring reconstruction and evaluate the type and timing of surgical intervention.
Methods: Retrospective review of pediatric hand burn patients from 2007 -2017. Demographics, type of hand injury, total body surface burn percentage, type and number of operative procedures and age at each operation were reviewed.
Results: Preliminary data of 52 patients demonstrated 67% of patients were Caucasian, 57% male, mean TBSA 33% (mean full thickness TBSA 18%); majority of injuries being flame (60%) or contact induced (22%). Over 85% of original injuries occurred < 5 years old and 25/52 patients sustained their injury at one year old; mean of 3 reconstructive surgeries occurred per person with an increased trend of reconstructive surgeries seen at age 8-9 years, 13-15 years and 17 years. Reconstructive procedures consisted of z- plasties ( 44%), full thickness skin grafts (32%), split thickness skin grafts (20%).
Conclusions: Pediatric burn hand injury primarily occurs in children less than 5 years with future reconstructive needs that require a mean of 3 surgeries, most frequently occurring in the adolescent years. More data acquisition will clarify the role of operative timing in this patient population that can then be used for parent education.
