Management of Postburn Recalcitrant Knee Ulcers in Pediatric Patients

Prema Dhanraj, Malachy Asuku, Seunghee Oh, Robert L. McCauley

    Research output: Contribution to journalArticle

    2 Scopus citations

    Abstract

    The sequelae of severe lower-extremity burn injuries in children include ulcerations and unstable scars of the anterior knee. Although the weight-bearing and ambulatory demands on this joint predispose the ulcers to chronicity, recalcitrance to treatment in the absence of systemic factors may be indicative of the presence of less-than-optimal local factors mitigating against healing. In our experience, excessive skin tightness around the knee joint has played a key role in this respect. This retrospective study on 10 patients with 16 recalcitrant knee ulcers demonstrated the inadequacy of the traditional treatment approach of ulcer excision and grafting. However, incisional release of tight skin above the knee joint and resurfacing the defect with split-thickness skin graft (mean size, 118.26 ± 35.32 cm 2) eliminated excessive tension and allowed the ulcers to heal spontaneously and permanently. We found this approach useful in select patients, and we are favorably disposed to additional releasing incision and grafting if the need arises in the growing child.

    Original languageEnglish (US)
    Pages (from-to)129-133
    Number of pages5
    JournalJournal of Burn Care and Rehabilitation
    Volume25
    Issue number1
    DOIs
    StatePublished - Jan 2004

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    ASJC Scopus subject areas

    • Rehabilitation
    • Surgery
    • Nursing(all)
    • Health Professions(all)
    • Emergency Medicine

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