Uso de sustituto dérmico en niños con secuelas de quemaduras. Tres casos clínicos

Abstract

Background: In COANIQUEM, burn sequelae ambulatory reconstructive surgeries in pediatric patients are performed during their rehabilitation treatments. One of these surgeries is the traditional technique of postburn contracture release and split-thickness skin grafting. A new alternative has been the appearance of a dermis substitute (Integra, Dermal Regeneration Template). There is no previous experience in Chile with this artificial skin applied in children with burn sequelae. Objective: Evaluate the ambulatory utilization of this dermis substitute in pediatric patients with burn sequelae and their evolution during two years. Case-reports: Surgeries carried out during 2004 in three patients 9 to 13 years-old, with upper extremity esthetic - functional sequelae. 24 months after surgery, a life- quality test (BSHS) and a rehabilitation protocol were applied. Results: There were no surgical complications in the three patients; the grafting attachment percentage varied between 75 and 100%. All of them needed compression therapy for 13 months. The elasticity and folding were similar to normal skin two years after evolution, with absence of fibrosis and graft contraction. BSHS was favourable. One case presented mild infection. Conclusion: Dermis cutaneous substitute Integra constitutes a good treatment alternative and its ambulatory use is possible without surgical complications.