A 76-year-old male with paroxysmal atrial fibrillation and hypertension who suffered from flame contact burns due to inflammation of his clothes when he lived with a burn victim.
The patient had deep dermal burns on the posterior surface of the right foot, knee and back of the left foot, posterior surface of the right thigh and glue, and subdermal burns on the anterior surface of the right thigh.
The rest of the burns were superficial dermal on the anterior part of the right thigh, lateral surface of the thigh and anterior surface of the left thigh.
Total body surface area was 30%.
After completing the initial resuscitation and with the patient clinically stabilized, we performed 2 sessions of debridement of the meshed areas during the first 2 weeks of hospitalization, and coverage of the left partial dermatome with deep white skin defects.
During the postoperative period, we observed loss of the graft from the anterior surface of the right atrium due to persistent surface area.
Twenty days after a new surgical session with debridement of this lesion, which required excision of the periosteum In an exposed bone voiding was performed on the posterior bone, a coverage defect with bone exposure 25 cm was applied.
After surgery the patient received prophylactic systemic antibiotic therapy with amoxicillin-clavulanate for 2 weeks.
1.
As in the previous case, we applied vacuum therapy with VAC® device continuously at 125 mmHg.
Cures were also performed in the same way and no new surgical debridement sessions were necessary.
After 40 days of vacuum therapy, we obtained a covering bed with granulation tissue, which subsequently did not exhibit bone exposure, with partial thigh skin, with immediate wounds being treated with complete postoperative wound closure.
1.
The patient was discharged after 110 days of hospital stay, which was partially prolonged due to worsening of his cardiac arrhythmia.
At discharge he walked independently with a walker and continued with outpatient rehabilitation sessions.
