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Prognosis of Full-Thickness Skin Defects in Premature Infants

  • Moon, Hyung Suk (Department of Plastic and Reconstructive Surgery, Kyung Hee University School of Medicine) ;
  • Burm, Jin Sik (Department of Plastic and Reconstructive Surgery, Kyung Hee University School of Medicine) ;
  • Yang, Won Yong (Department of Plastic and Reconstructive Surgery, Kyung Hee University School of Medicine) ;
  • Kang, Sang Yoon (Department of Plastic and Reconstructive Surgery, Kyung Hee University School of Medicine)
  • Received : 2012.05.08
  • Accepted : 2012.07.11
  • Published : 2012.09.15

Abstract

Background In the extremities of premature infants, the skin and subcutaneous tissue are very pliable due to immaturity and have a greater degree of skin laxity and mobility. Thus, we can expect wounds to heal rapidly by wound contraction. This study investigates wound healing of full-thickness defects in premature infant extremities. Methods The study consisted of 13 premature infants who had a total of 14 cases of full-thickness skin defects of the extremities due to extravasation after total parenteral nutrition. The wound was managed with intensive moist dressings with antibiotic and anti-inflammatory agents. After wound closure, moisturization and mild compression were performed. Results Most of the full-thickness defects in the premature infants were closed by wound contraction without granulation tissue formation on the wound bed. The defects resulted in 3 pinpoint scars, 9 linear scars, and 2 round hypertrophic scars. The wounds with less granulation tissue were healed by contraction and resulted in linear scars parallel to the relaxed skin tension line. The wounds with more granulation tissue resulted in round scars. There was mild contracture without functional abnormality in 3 cases with a defect over two thirds of the longitudinal length of the dorsum of the hand or foot. The patients' parents were satisfied with the outcomes in 12 of 14 cases. Conclusions Full-thickness skin defects in premature infants typically heal by wound contraction with minimal granulation tissue and scar formation probably due to excellent skin mobility.

Keywords

References

  1. Cunningham FG, Leveno KJ, Bloom SL, et al. Fetal growth and development. In: Cunningham FG, Leveno KJ, Hauth JC, editors. Williams obstetrics. 22nd ed. Philadelphia: McGraw-Hill; 2005. p. 91-120.
  2. Stoll BJ, Adams-Chapman I. The high-risk infant. In: Kliegman RM, Behrman RE, Jenson HB, et al., editors. Nelson textbook of pediatrics. 18th ed. Philadelphia: Saunders Elsevier; 2007. p. 698-711.
  3. Broughton G 2nd, Janis JE, Attinger CE. Wound healing: an overview. Plast Reconstr Surg 2006;117:1e-S-32e-S.
  4. Li J, Chen J, Kirsner R. Pathophysiology of acute wound healing. Clin Dermatol 2007;25:9-18. https://doi.org/10.1016/j.clindermatol.2006.09.007
  5. Lorenz HP, Longaker MT. Wound healing: repair biology and wound and scar treatment. In: Mathes SJ, Hentz VR,editors. Plastic surgery. 2nd ed. Philadelphia: Saunders Elsevier; 2006. p. 209-34.
  6. Ferguson MW, O'Kane S. Scar-free healing: from embryonic mechanisms to adult therapeutic intervention. Philos Trans R Soc Lond B Biol Sci 2004;359:839-50. https://doi.org/10.1098/rstb.2004.1475
  7. Dang C, Ting K, Soo C, et al. Fetal wound healing current perspectives. Clin Plast Surg 2003;30:13-23. https://doi.org/10.1016/S0094-1298(02)00067-6
  8. Longaker MT, Adzick NS. The biology of fetal wound healing: a review. Plast Reconstr Surg 1991;87:788-98. https://doi.org/10.1097/00006534-199104000-00032
  9. Lorenz HP, Longaker MT, Perkocha LA, et al. Scarless wound repair: a human fetal skin model. Development 1992;114:253-9.
  10. Longaker MT, Whitby DJ, Ferguson MW, et al. Adult skin wounds in the fetal environment heal with scar formation. Ann Surg 1994;219:65-72. https://doi.org/10.1097/00000658-199401000-00011
  11. Afsar FS. Skin care for preterm and term neonates. Clin Exp Dermatol 2009;34:855-8. https://doi.org/10.1111/j.1365-2230.2009.03424.x
  12. Fox MD. Wound care in the neonatal intensive care unit. Neonatal Netw 2011;30:291-303. https://doi.org/10.1891/0730-0832.30.5.291
  13. Fluhr JW, Darlenski R, Taieb A, et al. Functional skin adaptation in infancy-almost complete but not fully competent. Exp Dermatol 2010;19:483-92. https://doi.org/10.1111/j.1600-0625.2009.01023.x
  14. Lane AT. Human fetal skin development. Pediatr Dermatol 1986;3:487-91. https://doi.org/10.1111/j.1525-1470.1986.tb00656.x
  15. Cartlidge PH, Fox PE, Rutter N. The scars of newborn intensive care. Early Hum Dev 1990;21:1-10. https://doi.org/10.1016/0378-3782(90)90105-R

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