Effect of graft bed on long-term functional results of extremity skin grafts.

The purpose of the current study was to determine whether the long-term functional results of extremity burns grafted on fat were different from those grafted on fascia. Twelve patients (mean burn size, 38% TBSA) who had fascial excision of the majority of one or more extremities were examined a minimum of one year postinjury. Range of motion, motor strength, and sensation of the fascially excised extremities were measured. Twelve comparable patients with extremity burns (mean burn size, 35% TBSA) who had grafts placed on fat were used as positive controls. Patients whose burns were excised to fat had better joint mobility (P = 0.001) and sensory function (P = 0.001) than did patients whose burns were excised to fascia. Both groups had comparable muscle strength. These results indicate that patients with full-thickness burns of the extremities who have grafts placed on fat have significantly better long-term extremity function than do patients who have their skin grafts placed on fascia.