Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Genral Surgery

Background: The management of paediatric burns is always challenging, due to limited donor site & in addition to the cosmetic appearance that will affect the child later in life, either the donor or the recipient site. To minimize donor skin size or with patients with limited donor sites, skin grafts may need to be expanded. Patients &Methods: a prospective comparative randomized study was done from January 2019 till June 2020, on 40 paediatric burn patients with deep dermal and full thickness burns. There were 28 scald injuries & 12 flame injuries, mean age was 5.89 years, the mean total body surface area was 18.23% and the mean deep dermal and full thickness burnt area that required grafting was 12.27%. They were divided into two groups, Meek and meshed groups. The skin graft take, epithelialization time, total time of the surgery, and the aesthetic outcomes in each group were evaluated. After the operations, the patients were followed up for 3 months to evaluate the postoperative outcomes. Results: The percentage of take in the Meek group (84.25%) was significantly betterthan with the meshed group (71.5%) (P = 0.006).Epithelialization time was better for the Meek group, but the P = 0.176. In addition, infection rates were lower in the Meek group (25%) than the meshed group (40%) (P = 0.311). Subjectively we evaluated the scars using the PSOAS scar assessment scale.The patient{u2019}s overall score exhibitedbetter results for the Meek group with a mean score of 3.17& for the meshed group was 4.2 (P = 0.048). The observer{u2019}s overall score as well was better for the Meek group with a mean score of 2.89&for the meshed group was 4.1 (P = 0.003). The operative time was longer with the Meek technique than the traditional mesher (P < 0.001)

Issued also as CD