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Full
Thickness Burn: Meshed Autograft (Use of Silver Delivery)
Case
4:
The
patient is a 78 year old obese (310 lb) woman who suffered
full thickness burns to 34% of body surface including the
arm, left chest, back, and left leg. The injury occurred
from flames when clothing caught fire in a kitchen fire. The
moist silver membrane was applied to all burn areas, after
initial washing of surface, followed by a thick dry
dressing. Body temperature was well maintained and the
patient was very comfortable. The burn areas were managed
with the silver membrane (ACTICOAT) until excised and
grafted, changing the Acticoat every 2-3 days. The eschar
remained intact with minimal to no bacterial growth. Meshed
autografts were covered with the silver delivery system,
changing the Acticoat every 2-3 days. The graft sites
remained free of bacteria and of exudate. A darkish silver
hue could be seen on the graft surface. Rapid re-epithelialization
of the mesh was noted with excellent take. The patient never
demonstrated any evidence of infection and remained very
stable. She was transferred to our acute rehabilitation
center 26 days post burn.
Case
4: Full Thickness burns to back, flank and axilla are seen
on admission
(Click to Enlarge Image)
Silver
Delivery System in place
(Click to Enlarge Image)
Note:
Acticoat on for 3 days, ready to be changed. Delivery System
intact and formfitting to the back burn.
Case
4:
Post Burn Day 18
Back Graft Day 10
Flank Graft Day 14
(Click to Enlarge Image)
Note:
Acticoat in place for 3 days: Ready to be removed
Back Graft
Day 10
(Click to Enlarge Image)
Note:
Acticoat folded back with mesh graft nearly filled in. No
exudate: Silver staining on lower graft
Acticoat
removed
Flank graft, 14 days after placement
(Click
to Enlarge Image)
Use of Silver Delivery in
Full Thickness Burns on Meshed Autografts
Full Thickness burns to back (Day 2 post-burn)
(Click to Enlarge Image)
Note:
absence of pseudo eschar or exudate build-up with ACTICOAT
removal
Full Thickness Burn - Day 4 Post-Excision - Graft
(Click
to Enlarge Image)
Note:
Rapid re-epithelialization of 3:1 mesh graft, no exudate
below ACTICOAT. Eschar is intact on buttocks being treated
with ACTICOAT as well.
  
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