Hyperpigmentation after Full Thickness Skin Grafts–A Case Report

Author(s): Staubach R, Koehler P, Glosse H, Loff S

We report on an eight-year-old female patient of our department of pediatric surgery. In 2015 she was admitted to the emergency department at the age of one for burns she suffered from a barbecue accident. The admitting personnel were told that the child grabbed a piece of glowing charcoal with both hands burning a considerable part of her palms' and forearms' skin. The burnt surface showed partial blistering and made up approximately 1.5% of the child’s body surface. Primary treatment included covering with UrgoTul and Polyhexanide followed by a Suprathel skin substitution. Eighteen days after the accident a split thickness skin transplantation from the head to both palms was performed. Despite adequate wound healing supported by compression and extension therapy restrictive scarring occurred followed by a full thickness skin transplantation from the groin to the right hand. 24 months after the initial autotransplantation a dark discoloration of the right hand's transplant was noted (Figure 1). Five years after the full skin autotransplantation multiple scar releases were performed: a jumping man plasty and two z-plasties (Figure 2).