Bolgiani A, Patino O, Benaim F
Rehabilitation Department, Klgo. Ftra. Osvaldo Patino, Rehabilitation Department, Buenos Aires, Argentina.
J Burn Care Rehabil. 1993 Jul-Aug;14(4):466-70. doi: 10.1097/00004630-199307000-00014.
Because of the difficulty in handling a patient with cultured epidermal autografts in pressure areas of the limbs, we have adopted a splint that is easy to apply, allows an easy access to the wound, and is well tolerated by the patient.
Avoiding pressure in areas with autografts is recommended. This is the reason we have used a splint that avoids the pressure and the secretion buildup. This technique helps a better "take of the grafts."
We have modified the original Thomas splint in two ways: (1) the use of a distant and upper appliance that allows to correct the foot's flexion; and (2) the use of an appliance that can be regulated, is inflatable, and can be removed, allowing the change of pressure in different areas. We have used this method with one patient with a deep degree of circumferential burn in both lower limbs. The splint has been maintained and the elevation changed every day for 15 days. Traction has been made with the use of the Kirschner stirrup.
The dressing was changed easily and without patient pain. Good mobility was possible, with genital hygiene and grafts that were taken in 70% of the cultured epidermal autografts.
This method allows maintenance of the legs in functional position during dressing changes and avoids pressure and chafing. It decreases the loss of the autograft for mechanical effects.
由于在四肢受压部位处理接受培养的自体表皮移植的患者存在困难，我们采用了一种易于应用、便于接触伤口且患者耐受性良好的夹板。
建议避免在有自体移植的部位施加压力。这就是我们使用能避免压力和分泌物积聚的夹板的原因。这种技术有助于更好地“使移植片存活”。
我们对原始的托马斯夹板进行了两方面的改进：（1）使用一个位于远处且较高的装置，以纠正足部的屈曲；（2）使用一种可调节、可充气且可移除的装置，以便在不同区域改变压力。我们对一名双下肢深度环形烧伤的患者采用了这种方法。夹板持续使用，每天更换抬高方式，持续15天。使用克氏针进行牵引。
换药操作简便，患者无疼痛。患者能够保持良好的活动能力，生殖器卫生良好，70%的培养自体表皮移植片存活。
这种方法在换药期间能使腿部保持功能位，避免压力和摩擦。它减少了因机械作用导致的自体移植片丢失。
