Bold to do - bald to be? Outcomes decades after harvesting the scalp in burned children.


Journal

Burns : journal of the International Society for Burn Injuries
ISSN: 1879-1409
Titre abrégé: Burns
Pays: Netherlands
ID NLM: 8913178

Informations de publication

Date de publication:
05 2019
Historique:
received: 09 04 2018
revised: 03 09 2018
accepted: 13 09 2018
pubmed: 20 10 2018
medline: 25 1 2020
entrez: 20 10 2018
Statut: ppublish

Résumé

The scalp is the only hidden donor site for split thickness skin grafts. Nevertheless, it is underappreciated due to fear of iatrogenic scarring alopecia. Long-term data showing whether androgenetic hair loss can reveal previously hidden scarring alopecia is unavailable. We aimed to evaluate results and patient satisfaction up to 30years after skin harvest from the scalp. Burn patients, hospitalized between 1977 and 1987 at the University Children's Hospital Zurich with scalp skin harvest and currently over 30years old, were studied. Medical records and patient satisfaction were analyzed, and a clinical scalp examination was performed. Thirty-two patients (18 males, 14 females) with a current age of 34.13±3.42years participated. Mean follow-up time was 27.09±3.04years. Fifty-four scalp harvests were performed with 1.69±0.96 sequential harvests. Hair growth was considered normal in 97% patients. Androgenetic alopecia (AGA) type Norwood II-VI was seen in 11 patients. Scalp examination revealed 11 unknown likely harvest-related alopecias with a mean size of 0.7cm Long-term morbidity of scalp skin harvest and the risk of clinically significant alopecia is very low while patient satisfaction is high. AGA is unlikely to reveal harvest damage previously hidden by regrown hair.

Sections du résumé

BACKGROUND
The scalp is the only hidden donor site for split thickness skin grafts. Nevertheless, it is underappreciated due to fear of iatrogenic scarring alopecia. Long-term data showing whether androgenetic hair loss can reveal previously hidden scarring alopecia is unavailable. We aimed to evaluate results and patient satisfaction up to 30years after skin harvest from the scalp.
METHODS
Burn patients, hospitalized between 1977 and 1987 at the University Children's Hospital Zurich with scalp skin harvest and currently over 30years old, were studied. Medical records and patient satisfaction were analyzed, and a clinical scalp examination was performed.
RESULTS
Thirty-two patients (18 males, 14 females) with a current age of 34.13±3.42years participated. Mean follow-up time was 27.09±3.04years. Fifty-four scalp harvests were performed with 1.69±0.96 sequential harvests. Hair growth was considered normal in 97% patients. Androgenetic alopecia (AGA) type Norwood II-VI was seen in 11 patients. Scalp examination revealed 11 unknown likely harvest-related alopecias with a mean size of 0.7cm
CONCLUSIONS
Long-term morbidity of scalp skin harvest and the risk of clinically significant alopecia is very low while patient satisfaction is high. AGA is unlikely to reveal harvest damage previously hidden by regrown hair.

Identifiants

pubmed: 30337156
pii: S0305-4179(18)30845-3
doi: 10.1016/j.burns.2018.09.023
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

543-553

Informations de copyright

Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

Auteurs

Kathrin Neuhaus (K)

Pediatric Burn Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, University Children's Hospital Zurich, Steinwiesstrasse 75, 8700 Zurich, Switzerland; Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8700 Zurich, Switzerland.

Clemens Schiestl (C)

Pediatric Burn Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, University Children's Hospital Zurich, Steinwiesstrasse 75, 8700 Zurich, Switzerland; Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8700 Zurich, Switzerland. Electronic address: clemens.schiestl@kispi.uzh.ch.

Rosmarie Adelsberger (R)

Pyramid Clinic at the Lake, Centre for Plastic Surgery, Bellerivestrasse 34, 8034 Zurich, Switzerland.

Lisa Weibel (L)

Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8700 Zurich, Switzerland; Pediatric Dermatology Department, University Children's Hospital Zurich, Steinwiesstrasse 75, 8700 Zurich, Switzerland; Dermatology Department, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.

Martin Meuli (M)

Pediatric Burn Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, University Children's Hospital Zurich, Steinwiesstrasse 75, 8700 Zurich, Switzerland; Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8700 Zurich, Switzerland.

Sophie Böttcher-Haberzeth (S)

Pediatric Burn Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, University Children's Hospital Zurich, Steinwiesstrasse 75, 8700 Zurich, Switzerland; Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8700 Zurich, Switzerland.

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