Lancien Ugo, Mahe Pierre-Joachim, Lepelletier Aline, Leize-Zal Elisabeth, Lantieri Laurent, Perrot Pierre
From the Department of Plastic and Reconstructive Surgery, University Hospital of Nantes, Nantes, France.
RMeS: Regenerative Medicine and Skeleton Research Unit - INSERM, Nantes University, Nantes, France.
Plast Reconstr Surg Glob Open. 2025 Jul 1;13(7):e6930. doi: 10.1097/GOX.0000000000006930. eCollection 2025 Jul.
A 34-year-old patient with no medical history was admitted following severe thermal burns (>85% of the body surface area), including deep second- and third-degree injuries. Surgical management aimed to heal the entire upper body (thorax, abdomen, and back) using topical oxygen therapy (TOT) on the deep second-degree burns, without burn excision or skin grafting, while processing conventional management of the remaining burned areas alongside specialized intensive care. TOT was performed using an innovative oxygenating dressing (HEMHealing, Hemarina SA, Morlaix, France) combined with conventional excisional, allograft, and autograft management (4 surgical steps) on the hands, upper limbs, and lower limbs; the protocol enabled graft-free healing of the abdomen, thorax, and back within around 5 weeks. Despite a prolonged healing time (47 d, beyond the dogma of 2-3 wk), at 12 months follow-up, the scars showed very little inflammation and no hypertrophy on the trunk and the back. The patient did not require compression garments on TOT-treated sites. We report the use of this innovative dressing-in parallel with resuscitation and conventional surgery-and the very favorable evolution of this patient confirms this choice in retrospect. We now need to consider other cases and studies to validate our initial clinical results.
一名无病史的34岁患者在遭受严重热烧伤(体表面积>85%)后入院,包括深二度和三度烧伤。手术治疗旨在通过对深二度烧伤采用局部氧疗(TOT)来治愈整个上半身(胸部、腹部和背部),无需进行烧伤切除或皮肤移植,同时对其余烧伤部位进行常规处理并给予专门的重症监护。TOT使用一种创新的充氧敷料(HEMHealing,法国莫尔莱的Hemarina SA公司),并对手部、上肢和下肢采用传统的切除、同种异体移植和自体移植处理(4个手术步骤);该方案使腹部、胸部和背部在约5周内实现无移植愈合。尽管愈合时间延长(47天,超出了2 - 3周的传统认知),但在12个月的随访中,躯干和背部的疤痕炎症非常轻微且无增生。患者在接受TOT治疗的部位无需使用压力衣。我们报告了这种创新敷料与复苏及传统手术并行使用的情况,该患者非常良好的病情进展在回顾时证实了这一选择。我们现在需要考虑其他病例和研究来验证我们最初的临床结果。