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Meek Micro-Skin Grafting and Acellular Dermal Matrix in Pediatric Patients: A Novel Approach to Massive Extravasation Injury

(1) Background: Extravasation injuries in pediatric patients can lead to significant harm if they are not promptly diagnosed and treated. However, evidence-based standardization on extravasation management remains limited, particularly for extensive wound necrosis. This case report presents the mana...

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Autores principales: Maruccia, Michele, Tedeschi, Pasquale, Corrao, Claudia, Elia, Rossella, La Padula, Simone, Di Summa, Pietro G., Maggio, Giulio M. M., Giudice, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380205/
https://www.ncbi.nlm.nih.gov/pubmed/37510702
http://dx.doi.org/10.3390/jcm12144587
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author Maruccia, Michele
Tedeschi, Pasquale
Corrao, Claudia
Elia, Rossella
La Padula, Simone
Di Summa, Pietro G.
Maggio, Giulio M. M.
Giudice, Giuseppe
author_facet Maruccia, Michele
Tedeschi, Pasquale
Corrao, Claudia
Elia, Rossella
La Padula, Simone
Di Summa, Pietro G.
Maggio, Giulio M. M.
Giudice, Giuseppe
author_sort Maruccia, Michele
collection PubMed
description (1) Background: Extravasation injuries in pediatric patients can lead to significant harm if they are not promptly diagnosed and treated. However, evidence-based standardization on extravasation management remains limited, particularly for extensive wound necrosis. This case report presents the management of an 8-week-old premature patient with an extensive extravasation injury involving the right forearm and dorsum of the hand. (2) Methods: The patient was evaluated by a multidisciplinary team in our Neonatal Intensive Care Unit. Surgical intervention involved the debridement of necrotic tissues, followed by temporary coverage with an acellular dermal matrix. Definitive coverage was achieved through Meek micrografting after three weeks. Physical therapy was provided with pre- and post-rehabilitation range of motion assessed using goniometric measurements. Scar quality was evaluated using the Vancouver Scar Scale. (3) Results: The engraftment rate of the Meek micrografts was 93%, with 16 out of 226 micrografts lost. The patient achieved a Vancouver Scar Scale score of 6, indicating a moderate degree of scarring. Significant improvements in elbow, wrist, and finger joint range of motion were observed at a 1-year follow-up. (4) Conclusions: Close observation and heightened awareness of extravasation risks by trained personnel are crucial. Meek micrografting combined with dermal substitute coverage represents an innovative approach to managing extravasation wounds in pediatric patients.
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spelling pubmed-103802052023-07-29 Meek Micro-Skin Grafting and Acellular Dermal Matrix in Pediatric Patients: A Novel Approach to Massive Extravasation Injury Maruccia, Michele Tedeschi, Pasquale Corrao, Claudia Elia, Rossella La Padula, Simone Di Summa, Pietro G. Maggio, Giulio M. M. Giudice, Giuseppe J Clin Med Case Report (1) Background: Extravasation injuries in pediatric patients can lead to significant harm if they are not promptly diagnosed and treated. However, evidence-based standardization on extravasation management remains limited, particularly for extensive wound necrosis. This case report presents the management of an 8-week-old premature patient with an extensive extravasation injury involving the right forearm and dorsum of the hand. (2) Methods: The patient was evaluated by a multidisciplinary team in our Neonatal Intensive Care Unit. Surgical intervention involved the debridement of necrotic tissues, followed by temporary coverage with an acellular dermal matrix. Definitive coverage was achieved through Meek micrografting after three weeks. Physical therapy was provided with pre- and post-rehabilitation range of motion assessed using goniometric measurements. Scar quality was evaluated using the Vancouver Scar Scale. (3) Results: The engraftment rate of the Meek micrografts was 93%, with 16 out of 226 micrografts lost. The patient achieved a Vancouver Scar Scale score of 6, indicating a moderate degree of scarring. Significant improvements in elbow, wrist, and finger joint range of motion were observed at a 1-year follow-up. (4) Conclusions: Close observation and heightened awareness of extravasation risks by trained personnel are crucial. Meek micrografting combined with dermal substitute coverage represents an innovative approach to managing extravasation wounds in pediatric patients. MDPI 2023-07-10 /pmc/articles/PMC10380205/ /pubmed/37510702 http://dx.doi.org/10.3390/jcm12144587 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Maruccia, Michele
Tedeschi, Pasquale
Corrao, Claudia
Elia, Rossella
La Padula, Simone
Di Summa, Pietro G.
Maggio, Giulio M. M.
Giudice, Giuseppe
Meek Micro-Skin Grafting and Acellular Dermal Matrix in Pediatric Patients: A Novel Approach to Massive Extravasation Injury
title Meek Micro-Skin Grafting and Acellular Dermal Matrix in Pediatric Patients: A Novel Approach to Massive Extravasation Injury
title_full Meek Micro-Skin Grafting and Acellular Dermal Matrix in Pediatric Patients: A Novel Approach to Massive Extravasation Injury
title_fullStr Meek Micro-Skin Grafting and Acellular Dermal Matrix in Pediatric Patients: A Novel Approach to Massive Extravasation Injury
title_full_unstemmed Meek Micro-Skin Grafting and Acellular Dermal Matrix in Pediatric Patients: A Novel Approach to Massive Extravasation Injury
title_short Meek Micro-Skin Grafting and Acellular Dermal Matrix in Pediatric Patients: A Novel Approach to Massive Extravasation Injury
title_sort meek micro-skin grafting and acellular dermal matrix in pediatric patients: a novel approach to massive extravasation injury
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380205/
https://www.ncbi.nlm.nih.gov/pubmed/37510702
http://dx.doi.org/10.3390/jcm12144587
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