Effective administration of cranial drilling therapy in the treatment of fourth degree temporal, facial and upper limb burns at high altitude: A case report

World Journal of Clinical Cases
Cong-Mo ShenYong-Zhang Qi

Abstract

Fourth degree burns damage the full thickness of the skin and affect underlying tissues. Skin grafting after debridement is often used to cover the wounds of salvageable severe burns. A granulation wound can be formed by drilling the skull to the barrier layer to solve the problem of skull exposure. Low oxygen levels present at high altitudes aggravate ischemia and hypoxia which can negatively impact wound healing. The impaired healing in such cases can be ameliorated by hyperbaric oxygen therapy. We describe a patient who presented with fourth degree burns to the left temporal and facial regions upon admission in December 2018. The periosteum of the skull and the deep fascia of the face were exposed. After the first stage of debridement and skin grafting, the temporal skin did not survive well. Granulation was induced by cranial drilling, and then a local flap was transferred to cover the wound. The left temporal and facial wounds were completely covered and the patient recovered well. Skin grafting and flap transfer after early debridement to cover the wound and control infection were of great significance. In the later stages of the patient's treatment, survival of the skin graft and skin flap was observed. The second stage ...Continue Reading

References

Mar 3, 2011·Wound Repair and Regeneration : Official Publication of the Wound Healing Society [and] the European Tissue Repair Society·Dongmei XingJohn W Harmon
Jun 2, 2017·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Guozhen GaoHao Dong
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Mar 9, 2019·Journal of Periodontal & Implant Science·Heesuk AnMoon-Kyu Chung
May 3, 2019·Archives of Plastic Surgery·Jorge Humberto Rodríguez-QuinteroJesus Morales-Maza

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