[libribook.com] Traumatic Scar Tissue Management 1st Edition

16.06.2020 Views

Clinical ConsiderationMT may be a viable modality for attenuating post-burn hypertrophic scarpain, pruritus and scar characteristics such as thickness, melanindeposition, erythema, transdermal water loss and elasticity/tissue mobility(Cho et al. 2014).

Skin GraftsAs previously noted, the integument provides a protective barrier from externalinsults including trauma, radiation, harsh environmental conditions andinfection. Our skin also serves an important aesthetic role. When damaged,restoration of an intact and functioning barrier is of utmost importancephysiologically and psychologically.Skin graft procedures are performed as a means of barrier and aestheticrestoration. Full-thickness skin grafts (FTSG) include the entire thickness of thedermis. While split-thickness skin grafts (STSG) include the epidermis and onlya portion of the dermis.Wound condition, location, thickness, size and aesthetic concerns areconsiderations in determining which procedure is appropriate (Ratner 1998).STSGs serve a much broader range of application including resurfacing largewounds, mucosal deficits and muscle flaps, lining cavities and closing flap donorsites. STSGs are more fragile than FTSGs, typically not able to withstandradiation therapy, prone to mal-pigmentation in darker skinned individuals andcan contract significantly during healing. Thinness, abnormal pigmentation, lackof hair growth and inconsistent texture render STSGs less aesthetic. Althoughboth FTSG and STSG donor sites necessitate a second wound, the STSG donorsite must re-epithelialize, often resulting in significant discomfort and posing ahigher risk of infection (Ratner 1998).

Clinical Consideration

MT may be a viable modality for attenuating post-burn hypertrophic scar

pain, pruritus and scar characteristics such as thickness, melanin

deposition, erythema, transdermal water loss and elasticity/tissue mobility

(Cho et al. 2014).

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