Fluorescein Dye-Assisted Tangential Excision and Skin Grafting in Hand Burns: Achieving Optimal Cosmetic and Functional Outcomes.

Abstract

Background: Burned hands require special attention and prompt treatment because of their vital functional importance. With fluorescein dye, it is possible to visualize vascular dermal layers to assist with the removal of nonviable skin through tangential excision.

Methods: Within 24 to 48 hours after a burn, 5 mg of fluorescein dye was injected intradermally and a Wood light was used to determine burn depth. Under anesthesia, an Air Brown (Zimmer Biomet) or castroviejo dermatome and a free-hand or Humby knife was used to excise the burned skin. Split-thickness layers approximately 0.015 inches thick were removed until strong fluorescence was noted.

Results: Observation indicators were used to assess the quality of the skin graft outcomes. No cases of infection, seromas, hematomas, or contractures were seen. Additionally, patients experienced reasonable cosmetic and functional outcomes within weeks to months following grafting.

Conclusions: Excision and split-thickness skin grafting with fluorescein dye and tangential excision can achieve desirable results and restore both cosmetic and functional outcomes.