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First experiences with a new surgical approach in adult full-thickness burns: single step reconstruction of epidermal, dermal and subcutaneous defects by use of split-thickness skin grafting, a dermal collagen matrix and autologous fat-transfer

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An Erratum to this article was published on 17 August 2013

Summary

Background

Deep excision down to the muscle fascia and split-thickness skin grafting is a necessary part in modern surgical care of adult burn patients presenting with full-thickness wounds. We evaluated a new surgical approach combining a dermal matrix, autologous fat-transfer, and split-thickness skin grafting.

Methods

Full thickness burn wounds of five consecutive patients were excised down to the muscle fascia. Parts of the excised adipose tissues were harvested for in vitro analysis of preadipocyte viability and its potential for proliferation and differentiation. The excised fatty tissue was manually harvested by use of a Coleman Liposuction needle mounted on 10 ml syringes, and spread onto a bovine collagen-elastin scaffold (Matriderm®). The sheet was put upside down onto the wound and covered with split-thickness grafts during the same operation. Skin biopsies for histological evaluation were taken on days 30 and 90 postoperatively.

Results

Preadipocytes from excised burn wounds showed cell behavior comparable to healthy fat tissue. FACS Analysis showed 75 % viable cells in the samples which is comparable to healthy fat tissue. Three patients showed more than 90 % vital split thickness skin grafts 10 days after surgery. All skin biopsies confirmed the presence of adipose tissue.

Conclusions

Autologous fat-transfer in combination with a dermal substitute and split-thickness skin grafts seems to be a possible reconstructive procedure for covering defects after deep excision down to the fascia in a single step approach.

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Conflict of interest


This study was supported by MedSkin Solutions Dr. Suwelack, Billerbeck, Germany.

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Authors and Affiliations

  1. Vienna Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Waehringer Guertel 18–20, 1090, Vienna, Austria

    M. Keck MD, H. F . Selig MD, J. Kober MSc, D. B . Lumenta MD, A. Gugerell PhD & L-P. Kamolz MD, PhD, MSc

  2. Hospital for Hand Surgery, Rhoen Klinikum AG, Bad Neustadt/Saale, Germany

    H. F . Selig MD

  3. Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria

    D. B . Lumenta MD & L-P. Kamolz MD, PhD, MSc

  4. Department of Pathology, Medical University of Vienna, Vienna, Austria

    H. Schachner

Authors
  1. M. Keck MD
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  2. H. F . Selig MD
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  3. J. Kober MSc
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  4. D. B . Lumenta MD
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  5. H. Schachner
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  6. A. Gugerell PhD
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  7. L-P. Kamolz MD, PhD, MSc
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Correspondence to M. Keck MD.

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Keck, M., Selig, H. ..., Kober, J. et al. First experiences with a new surgical approach in adult full-thickness burns: single step reconstruction of epidermal, dermal and subcutaneous defects by use of split-thickness skin grafting, a dermal collagen matrix and autologous fat-transfer. Eur Surg 45, 263–269 (2013). https://doi.org/10.1007/s10353-013-0211-2

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  • DOI: https://doi.org/10.1007/s10353-013-0211-2

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