Articles Posted in Skin Graft

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It is a surgical procedure which involves the placement of a piece of healthy skin in areas where the skin is damaged. It is usually done in an operating room under local or general anesthesia depending on the size of the graft.

Skin grafts can be classified into:

  1. Autografts: where the skin for the graft is taken from the same person.
  2. Allograft: where the skin for the graft is taken from another person.
  3. Xenograft: where the skin for the graft is taken from animals (usually pigs).

A skin graft can be partial thickness where the first two layers of skin are taken, or full thickness skin grafts where the entire thickness of skin is taken which is done in patients with deeper tissue loss.

  • The area where the healthy skin is taken from is called the donor site.
  • The donor site can be any area of the body; it is usually in areas hidden by clothes like the inner thigh.
  • The area which receives the healthy skin is called the recipient site (the graft site).

The donor site will be covered with a dressing for the first one to two weeks. It usually heals within 10-14 days. Lotion is applied to the donor site after the dressing comes off.

For the recipient site (graft site) the dressing is left in place for two to five days before it is changed. The area is very fragile and great care should be taken to ensure that it is protected from trauma and heavy stretching for two to three weeks.

Complications:

  1. Infection.
  2. Bleeding.
  3. Graft failure.
  4. Graft rejection.
  5. Scarring.
  6. Skin discoloration.
  7. Chronic pain.
  8. Change in the sensitivity of skin.

Future care:

It is important to take care of the graft area by protecting it from excessive sun exposure, protect it from dryness (use ointment or creams after consulting with your doctor).

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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The lone survivor of a small-airplane crash in southeast Kansas recently underwent skin graft surgery to treat third degree burns across 28 percent of her body. Hannah Luce of Garden Valley, Texas, a recent graduate of Oral Roberts University, was flying with four others to a Christian youth rally in Iowa when their twin-engine Cessna crashed northwest of Chanute, Kansas.

All the other people, including the pilot, died in the crash. Hannah Luce is the daughter of Ron Luce, an Oral Roberts trustee and founder of Teen Mania Ministries, which was sponsoring the rally in Council Bluffs, Iowa. She was treated at the University of Kansas Hospital in Kansas City, Kansas. A spokesperson there said that Hannah was in serious condition but was expected to make a full recovery.

“She went into her first surgery for skin grafts on burns she suffered on her left leg, her arms and her hands,” said a spokesperson for the family. “The doctors are saying it’s a miracle Hannah didn’t suffer more internal trauma.” Hannah was off a respirator and breathing on her own several days after the crash, and was awake and answering questions before surgery.

However, “she’s dealing with the loss of four friends. They were all tremendous individuals,” the spokesperson said. “They all had a heart for reaching the younger generation.”

The National Transportation Safety Board is investigating what caused the crash. The pilot had a commercial pilot’s license, was certified for that aircraft, and had been flying for years. One other victim, a former Marine who had served two tours of duty in Iraq before attending Oral Roberts, might have helped Luce escape the crash site and get help before succumbing to his own burn injuries.

Once the surgery is complete, Hannah will have to undergo a lot of painful rehabilitation in order for her burn injuries to heal enough to allow her to lead a normal life again.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

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Zane Wetzel spent 47 days in a coma, and awoke to the realization that he was involved in a life-changing accident. But with the love of his wife and unwavering faith and optimism, he and his wife have gotten to a place where they can actually help other burn victims too.

It has been a little more than two years since the 27-year-old apprentice lineman for Maine Public Service Co. in Presque Isle, Maine suffered a flash burn to 50 percent of his body while working at an electrical substation. His chest, back, arm and neck suffered third degree burns in the accident.

Wetzel was standing on a scissor lift with several other co-workers when a charge of electricity arced and touched the corner of the lift. The electricity traveled to the ground and bounced back, burning him. Safety equipment prevented Wetzel from being fatally electrocuted. And no one else around him was injured.

Wetzel was in a drug-induced coma for 47 days in the intensive care unit at Brigham and Women’s Hospital in Boston. He has endured a dozen surgeries, including several operations to place skin graft from his legs onto his burned areas. After seven weeks, he was transferred from Brigham and Women’s to Spaulding Rehabilitation Hospital in Cambridge, Massachusetts. He spent two weeks in that hospital and remained in Boston for outpatient therapy before coming home at the end of January 2011. For several months, he spent up to 2½ hours a day, five days a week, at County Physical Therapy in Presque Isle working with therapists on exercises to increase his range of motion and mobility and improve his quality of life.

After Zane was released from the hospital, he and his wife Courtney began receiving invitations to speak at churches, Christian schools and other venues about the accident and its aftermath. They now have traveled all over New England and also spoke in Zane’s home state of Ohio.

“We always tag-team during these engagements because he doesn’t remember the first month after the accident and we had two different challenges,” said Courtney. “Mine was that I didn’t know if my husband would live. His was waking up and realizing the condition he was in.”

Wetzel still has virtually no memory of the accident. At the emergency room, “I remember being scared and confused, and then I heard my mother-in-law’s voice and I calmed down,” he said. “I remember whispering, ‘Tell Courtney I love her.'”

When Courtney arrived at the Boston hospital a few hours after the accident, she repeatedly asked doctors and nurses if Zane would live. They just stared in silence. “I really just had to put it in God’s hands,” she said. “I turned it over to Him.”

Zane’s family traveled to the hospital from Ohio to join Courtney and her loved ones. As they watched, he struggled. Feverish and thirsty, he thought he was being held captive in Mexico, the constant sedation leading him to believe that his captors were drugging him. His loved ones watched him kick and flail in his hospital bed, with Courtney humming “Amazing Grace” to him every night before she left.

The doctors assured her that one day Zane would just emerge from his sedation and start talking to her. That day was six weeks after the accident. Although he was still on the feeding tube, he began eating his first real meal of peaches and ice cream six days later. To the amazement of his family and caregivers, he was well enough to make a trip home for Christmas 2010.

Wetzel’s last operation was surgery on his neck in June 2011 and he will have additional neck surgery soon. He also may be facing a procedure on his thumb. “But hopefully, that will be the last one,” he said.

His physical therapy has decreased to three days a week and he is now lifting heavy weights. He has gained mobility and strength. He can lift weights over his head now, something he could not do a few months ago.

The biggest change, however, has been the public speaking. The Wetzels are strong in their faith. The couple said they’ve had unbelievable reactions when they tell their story in public. “I always people that your strength doesn’t come from you, God gives you the strength to get through,” said Courtney. “Things happen for a reason, and you have to be strong.”

During each session, Zane unbuttons his shirt and shows the audience his chest, which was the most severely burned in the accident. “I am not ashamed of my scars,” he said. “And we always get a positive reaction when we speak — lots of tears and people telling us how inspired they were by our story.”

Zane adds that “I do want to go back to work. I will talk to the doctors to determine what sort of job duties I can perform.”

Since he can’t expose his skin to sunlight for very long and has poor circulation in his hands, which makes him more susceptible to frostbite, he cannot go back to his position as a power lineman. Still, he wants to return to work in some fashion and has kept in contact with his colleagues, who he called “very supportive.”

The couple said they have amazing support from family, friends, and the community. They credited medical staff at both hospitals in Massachusetts as well Zane’s team at County Physical Therapy for his recovery. They now are back to making plans both personally and professionally and looking forward to their next steps after the long journey home.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

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A recent article from the Institute for NanoBioTechnology discussed the developments that Johns Hopkins researchers have made in creating a jelly-like material for burn wound treatment which, in early experiments on skin damaged by severe burns, seemed to regenerate healthy tissue with no sign of the previous burn scars.

In a mid-December report from the National Academy of Sciences, the researchers reported their promising results from tests using mouse tissue. The new treatment has not yet been tested on human patients, but the researchers say that the procedure, which promotes the formation of new blood vessels and skin, could lead to greatly improved healing for victims of third degree burns.

The treatment involved a simple wound dressing that included a specially designed hydrogel: a water-based, three-dimensional framework of polymers. This material was developed by researchers at Johns Hopkins’ Whiting School of Engineering, working with clinicians at the Johns Hopkins Bayview Medical Center Burn Center and the School of Medicine’s Department of Pathology.

Third degree burns typically destroy the several layers of skin right down to the muscle tissue. They require complex medical care and leave behind significant scars. But in the journal article, the Johns Hopkins team reported that its hydrogel method yielded much better results than typical outcomes. “This treatment promoted the development of new blood vessels and the regeneration of complex layers of skin, including hair follicles and the glands that produce skin oil,” said Sharon Gerecht, an assistant professor of chemical and biomolecular engineering, who was principal investigator on the study.

Gerecht said that the hydrogel could form the basis of an inexpensive burn wound treatment that works better than currently available clinical therapies, adding that the product would be easy to manufacture on a large scale. Gerecht suggested that because the hydrogel contains no drugs or biological components to make it work, the Food and Drug Administration would most likely classify it as a device. Further animal testing is planned before trials on human patients begin, but Gerecht said that “it could be approved for clinical use after just a few years of testing.”

John Harmon, a professor of surgery at the Johns Hopkins School of Medicine and director of Surgical Research at Bayview, described the mouse study results as “absolutely remarkable…We got complete skin regeneration, which never happens in typical burn wound treatment,” he said.

Gerecht says that the hydrogel is constructed in such a way that it allows tissue regeneration and blood vessel formation to occur very quickly. “Inflammatory cells are able to easily penetrate and degrade the hydrogel, enabling blood vessels to fill in and support wound healing and the growth of new tissue,” she said. For burns, Gerecht added, the faster this process occurs, the less there is a chance for scarring. After 21 days, the gel is harmlessly absorbed, and the tissue continues to return to the appearance of normal skin.

If the treatment succeeds in human patients, it could address a serious form of injury. Harmon, a co-author of the NAS journal article, pointed out that 100,000 third degree burns are treated in the U.S. every year in burn centers.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

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In late February, two Prince George’s County, MD firefighters were critically injured when a wind-fueled fireball blew through a burning house. They will survive, but the two members of the Bladensburg Volunteer Fire Department will face long, painful recoveries.

Ethan Sorrell, 21, sustained respiratory burns “through his esophagus and down to his lungs,” and Kevin O’Toole, 22, suffered second and third degree burns over 40 percent of his body when a basement fire suddenly turned a small house into something resembling a blast furnace.

O’Toole underwent skin graft surgery shortly after, and will be in the burn unit at the Washington Hospital Center for six weeks. He then faces six months of rehabilitation beyond that.

Doctors won’t know the full extent of the damage to Sorrell’s burned airway until they remove a breathing tube. His father, Vann — a volunteer firefighter in Buies Creek, NC — welled up when asked about his son’s bravery. “When you go into it, you know the dangers,” Sorrell said. But the Sorrells “just have that need to serve,” he added.

His son is unable to speak but has been communicating with a pen and paper. He seems to be in good spirits, said the local fire chief. “The first thing Ethan wrote to me on a pad was [that] the medic who transported him was attractive.”

Five volunteer firefighters were treated and released for burns and other injuries suffered in this incident, which as been called by fire officials a “freak occurrence.”

One of the injured was Michael McClary, who returned to the hospital two days after the fire with bandages wrapped around his hands, and his heart heavy. “He’s still upset that he got to go home and his brothers didn’t,” said his mother, Cheryl.

Michael, she said, wasn’t up to discussing publicly what happened at the house, where wind gusts apparently shot a column of flame up the stairs, through the first floor and out the front door.

The fire was extinguished quickly, said a fire commander who was directing a group in the basement at the time of the fireball.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

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In late February, a man suffered third degree burns from an unusual incident involving an overheated laptop computer. His burns were so severe that he had to be airlifted to a top burn treatment center for further care, including skin graft procedures to replace badly burned skin.

The 31-year-old man suffered burns on 60 percent of his body. The cause of his injuries was a fire that started in the bedroom from an overheated laptop computer which was left on while he took a shower. The victim was injured because he made a careless decision: He placed his laptop computer on the mattress of his bed before going into the shower. Laptop computers get hot when they are on, and their cooling and ventilation areas are near the bottom of the unit. So laptops must always be placed on a hard surface so that they can take in air to cool them off. In this instance, the heat from the computer was trapped, and eventually set the mattress on fire.

When the victim realized that the mattress and the bed were on fire, he tried to put it out with the help of his wife. Unfortunately for him, in his attempt to extinguish the fire, he suffered severe burns on his hands, arms, and legs. The fire was finally extinguished by a team of firemen who rushed to the scene after receiving a distress call from someone outside the home.

The lesson here is that electronics devices–iPads, laptops, and even smartphones–give off lots of heat, so they must not be left on any surface that can burn. There have even been burn accidents where laptop users severely burned their legs by placing the laptop in their lap to use it! Sometimes these devices become overheated from a product defect such as a short circuit, and this product defect could result in an injury lawsuit against the manufacturer.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

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A week ago, we wrote about a 70-year-old woman who fought through physical and psychological trauma she suffered from receiving third degree burns–and fought so well that she was able to walk again, and do many things on her own, even tough doctors never thought it would be possible.

Well, we have an even more unbelievable burn survivor story to share with you. Last month in the Morning Sun newspaper serving central Michigan, a writer chronicled the experience of Evelyn Clark, a 79-year-old who was burned in a gasoline fire in July 2011 and nearly died a few times since then. But Evelyn has recovered, and she spent what she calls “an extra special” Thanksgiving with her husband Jim, plus her children and her grandchildren at her home in Weidman, Michigan.

After being burned outside her home while pouring just a bit of gasoline in a barrel to start a controlled fire, Evelyn was rushed to at Spectrum Health Butterworth Campus in Grand Rapids. She suffered third degree burns on nearly 30 percent of her body, and then she developed pneumonia and another life-threatening condition while she was undergoing more than one skin graft.

Her daughter Colleen knew the burns were very bad when her mother declined pain medication–because her nerves were burned away, so she was feeling no pain. This is a very bad sign.

Evelyn does not remember much after arriving at Spectrum, where she was showered to remove dead skin. Then, donated skin was used to cover Evelyn’s burns until skin grafts could be taken from her legs. “Thank goodness for people who are willing to donate organs, even skin,” Colleen said. “The body rejects it but it serves its purpose [until the skin heals].”

Evelyn had burns on her right arm, chest and face. She was hospitalized for six weeks, and at one point was not expected to live because she contracted methicillin resistant staphylococcus aureus (MRSA), a bacterium that causes infections that are very hard to treat. Then, pneumonia set in.

Evelyn was put on a ventilator and taken to intensive care for five days. all throughout her hospital stay, though, Evelyn received not just the support of her family but also more than 150 cards from well-wishers, which is important for the psychological aspect of healing from burn wounds.

Fortunately, once Evelyn was placed on strong antibiotics, she started to recuperate and in a few days was out of intensive care and back in a room in the burn unit.

After spending several days in the hospital, physicians performed skin grafts, which were very painful, Evelyn said.

After being released from Spectrum, Evelyn spent 10 days at Masonic Pathways in Alma in rehabilitation. Once Evelyn went home, doctors told Colleen that Evelyn recovered because she is active and in good physical condition–and because she had people around her to keep her in a positive frame of mind.

Evelyn is thankful that she is still alive and that her family, friends, and local churches stood by her, and is thankful for all the prayers that were offered. She is now taking water aerobics classes and has become famous in the town.

If you or someone you know does suffer a severe burn injury or a smoke inhalation injury, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a solid legal case.

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In Maple Grove, Minnesota, a 15-year-old boy is spending a few days in a burn unit at Hennepin County Medical Center after a flash explosion in a science class that burned him and three other Maple Grove Junior High School students. The three others were treated and released, but the boy, Dane Neuberger, is still in the hospital suffering from second-degree burns on his face and neck.

Neuberger said he was simply taking notes in class when suddenly, and from seemingly out of nowhere, he was on fire. Neuberger was sitting in the front row of class when his teacher asked the ninth-graders to turn their desks toward a lab table while he conducted experiments. They were learning about the flammable substance methanol. But the flame that was supposed to stay in the bottle and consume the methanol did not do so, the container exploded.

The flame from the container came in contact with some spilled methanol that was left on a lab table, which caught fire. This is the fire that hit Neuberger in the face, neck and hand. It also caught his shirt, which he ripped off while the teacher rushed to help him.

“I was on fire. The teacher wrapped me with a fireproof blanket,” he recalled. “People were screaming and just ran out.” another student said that “I saw a kid running down the hallway, he was burned, black, with no shirt, running and screaming.”

Neuberger remembers that, “Immediately afterwards, I was in shock, so I didn’t feel much. But when I was sitting in the nurse’s office, the pain became unbearable– it felt like I didn’t have my lips.”

Dr. Ryan Fey, a surgeon at HCMC’s Burn Unit, affirmed the severity of Neuberger’s wounds: “Burns like these are quite painful.” But he offered some hope in saying that these burns may be able to heal without skin grafts and possibly without permanent burn scars. “If the wounds heal in about 10 days, then we’ll know,” Fey said. “Right now, we think the risk [of long-term scarring] is pretty minimal.”

Both the school district and state fire marshal are investigating the incident, to determine the exact cause and whether the teacher committed negligence in fire safety precautions.

Another accidental flash fire took place recently in Crestview, Florida. There, a woman was undergoing minor surgery at a medical center to remove cysts from her head when a blaze suddenly erupted in the operating room, leaving the woman with severe burns to her face and neck.

Kim Grice, a 29-year-old mother of three from Holt, Florida, was unconscious during the incident, which was fortunate. She was immediately flown to a hospital with a burn center in Alabama. It was not clear what caused the flash fire. The woman’s mother said that “Kim said to me, ‘They woke me up and everyone around me was hysterical. I don’t know what happened to me.'”

Perhaps because there will be an investigation into possible doctor negligence or nurse negligence in the operating room, or possible liability for a medical device maker that was in the operating room, “the doctors and the hospital are not telling us what happened,” said the woman’s uncle. “They did say they had never seen anything like it before, and they are terribly sorry that it happened.”

A statement from the facility, the North Okaloosa Medical Center, read: “The hospital deeply regrets today’s event in which a patient sustained burns during a procedure in our ambulatory surgery center. The staff took immediate steps to respond, including moving the patient to the hospital’s emergency department. . .We are conducting a thorough review to fully understand what happened in a deliberate effort to prevent such an event from occurring again.”

If you or someone you know does suffer a severe burn injury or a smoke inhalation injury, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injury suffered, and if the injured party has a solid legal case.

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There is an uplifting story on CNN.com today about a burn victim who is not only is healing physically from his burns, but also psychologically. Here’s the proof: The boy, Youssif, was given a “certificate of citizenship” recently, which is an award for being exceptionally nice to a fellow classmate in school. Another boy got hurt, and Youssif helped the boy with his gashed arm by applying an ice pack and helping to stop the bleeding.

Youssif is proud of his award–and his family, his doctors, and his entire support system should all be proud as well. Four years ago, Youssif suffered third degree burns to his face–much of it melted, actually–during a battle among local sects in Iraq. But after dozens of surgeries in the United States, doctors have been able to reverse a lot of the horrible burn scars. Not only that, but Youssif is no longer the sad, quiet child he was in the few years after his burn injury.

Through extensive counseling with his family, he is now able to cope with the facial scars he still has from the attack, and he also has an upbeat attitude that’s hard to believe. He says his looks no longer bother him, “because none of my other friends make fun of me,” he says in English. His mother is so happy to see her boy like he was before he was burned. “His personality has changed so much,” she told CNN.com. “The way he interacts with people, and everything else. It began as soon as he started school and realized that the children don’t care about his appearance. It allowed him to have a normal life.”

When CNN first aired Youssif’s story in 2007, viewers around the world responded to the family’s plea, donating hundreds of thousands of dollars to the Children’s Burn Foundation, a Los Angeles-based foundation that took on his case.

His mental recovery has by far outpaced his physical one. He still needs more surgeries. Treating Youssif has been challenging, his doctors say, because his skin tends not to heal well. His doctors want to slow down the pace of surgeries for now to determine how his burn scar tissue and skin will develop and change as he gets older.

He loves soccer and plays on a local team. “I never used to do that in my country,” he says, “because it was kind of dangerous there.” He loves the ocean, which he had never seen in Iraq.

And he wants to be a doctor so he can help others when he grows up.

If you or someone you know does suffer a severe burn injury or a smoke inhalation injury, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a solid legal case.

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Here is a research finding that could improve the recovery experience for pediatric patients who have suffered severe burns.

In mid-October, a study was released by researchers at Children’s Mercy Hospitals and Clinics in Kansas City, Missouri that says that fewer treatments are just as effective as the present standard of care given to children suffering from burns. The research was presented at the American Academy of Pediatrics National Conference and Exhibition in Boston.

“Given the risk of infection, dressings for burn patients need to be changed once or twice a day. This experience can be traumatic, especially for a young child,” said Daniel Ostlie, M.D., director, Surgical Critical Care at Children’s Mercy and lead investigator of the study. “If we can reduce this trauma just the slightest bit by eliminating one of the topical applications – with no major implications for outcome – we can make a significant improvement in the patient recovery experience.”

In the randomized study, researchers compared the effectiveness of two burn therapies commonly used to facilitate the healing process: topical silver sulfadiazine, which is an antimicrobial treatment; and collagenase ointment, which is an enzyme therapy. While silver sulfadiazine is frequently used for its anti-bacterial properties, collagenase ointment is believed to shorten the healing time of burn wounds.

“For all of our burn patients, we want to avoid more invasive treatment, such as skin graft, because these add another layer of distress for the patient and the family,” said Janine Pettiford, M.D., surgical scholar in the Department of Surgery at Children’s Mercy and an author of the study. “Non-invasive topical therapies have proven to be effective, but no studies have demonstrated if one treatment is more effective than another in reducing the odds that the patient would need a skin graft.”

Using a consistent intervention approach with both therapies, researchers found there was no difference in the need for skin grafting between the two therapies. Additionally, the cost difference between the therapies was insignificant.

Children’s Mercy Hospitals and Clinics is one of the nation’s top pediatric medical centers. The 314-bed hospital provides care for children from birth through the age of 18, and has been recognized by the American Nurses Credentialing Center with Magnet designation for excellence in nursing services, and ranked in U.S. News & World Report’s “America’s Best Children’s Hospitals” listing for all 10 specialties the magazine ranks.

I you or someone you know does suffer a severe burn injury or a smoke inhalation injury, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a solid legal case.