Successful management of deep facial burns in a patient with extensive third-degree burns: the role of a nanocrystalline silver dressing in facilitating resurfacing

Int Wound J. 2007 Mar;4(1):8-14. doi: 10.1111/j.1742-481X.2006.00263.x.

Abstract

Full-thickness burns of the face are notoriously difficult to repair and their management poses a series of problems to the surgeon. We present the case of a 49-year-old man (only survivor of a catastrophic airport accident) with third-degree flame burns to >80% of total body surface area and extensive face damage who achieved a fully satisfactory outcome after a treatment plan based on gradual escharectomy followed by application of artificial dermis and, later, grafting with sheets of cultured keratinocytes. Re-epithelialisation was already visible at day 16 after admission and all facial wounds were closed by day 56, the treatment continuing on the scalp. Within 6 months of the accident, the patient had recovered functional and cosmetic features (including re-growth of skin appendages) that were beyond expectations. The use of nanocrystalline silver-coated dressings during the escharectomy and resurfacing phases was important, as part of a multifaceted strategy, in ensuring excellent antimicrobial control, thus avoiding the need for autologous grafting and contributing to a rapid healing and complete restoration of the face and head skin.

Publication types

  • Case Reports

MeSH terms

  • Bandages*
  • Burns / therapy*
  • Cells, Cultured
  • Facial Injuries / therapy*
  • Humans
  • Injury Severity Score
  • Keratinocytes / transplantation
  • Male
  • Middle Aged
  • Polyesters / therapeutic use*
  • Polyethylenes / therapeutic use*
  • Skin, Artificial

Substances

  • Acticoat
  • Polyesters
  • Polyethylenes