36 years old, male, with full-thickness flame burn and inhalation injuries.
Fig. 1: Initial aspect 48 hours after injury, one can see the extensive surface of the lesion an the depth of the flame burn wound.
Fig. 2: Same patient 72 hours after injury, one can see the charred eschar which has begun to have a black color.
Fig. 3: The patient at the fifth day of evolution, in the operating room before the sharp debridement which usually means an incomplete tangential excision, thus preventing brisk bleeding that follows the most part of such interventions.
Fig. 4: Detail image to see the black, charred aspect of the full-thickness flame burn.
Fig. 5: Closer image of the same eschar, before tangential excision.
Fig. 6: Black, charred eschar in the same patient, on the right knee and leg, which has to be excised.
Fig. 7: Sharp debridement using a manual dermatome.
Fig. 8: 24 hours after incomplete tangential excision. A layer of eschar is still adherent on the burn wound and will be removed in the following period by passive debridement using LIGASANO® white, thus preventing excessive bleeding and preparing a very good bed to be grafted with STSG.
Fig. 9: Progressive detachment of the remaining eschar layer after several dressings with LIGASANO® white. Change of the dressing 3-4 times weekly.
Fig. 10: After about 6 weeks of passive debridement with LIGASANO® white a very good granulation tissue has developed, covering all the area of the full-thickness burn wound.
Fig. 11: All the granulatred areas have been covered with meshed STSG (auto-grafts) and the grafts have been sutured with absorbable separate sutures.
Fig. 12: Detail image during grafting and suturing the grafts.
Fig. 13: 10 days later the most part of the grafts “have taken”, excepting a small area on the right buttock and another on the anterior aspect of the right knee, which have to be re-grafted.
Fig. 14: Detail image of the previous picture showing the very good evolution of the grafted area, with small granular islands among the already integrated grafts, at about two weeks after grafting. This case is still in process, but the spectacular healing was achieved only by the passive debridement with LIGASANO® white.