MEDICA.de talked to Bernd Hartmann, head physician of the centre for badly burned people at the Unfallkrankenhaus Berlin, about the risk of having no sense of touch after a skin transplantation.
MEDICA.de: Mr. Hartmann, after a skin transplantation the patient may suffer from a sensory disturbance because nerve cells can be injured. Does this complication occur frequently?
Bernd Hartmann: With very heavy burns the body’s tactile sense of the nerves and skin cells is always lost. The structure inside the tissue are destroyed and replacing tissue is formed - scars in which the feeling is heavily disturbed. This can have very different dimensions though. Some patients have alleviated sensations others do not feel anything anymore in the treated area. With many patients the cells regenerate again. This always depends upon the gravity of the injury and how well a skin graft can rebuild the disturbed structures.
MEDICA.de: There are different methods of skin transplantations. Is there a specific one that is very suitable to save the body’s tactile sense of the skin or at least one that increases the chances of the sense returning later?
Hartmann: When we are concerned with burns of smaller skin sections we move a part of the patient's own epidermis to the affected area. This so called split-skin graft is very thin and heals quite quickly. However, the quality is not very good though. This type of skin has the tendency to shrink and the scar will often be ugly. When we are concerned with burns of larger areas we try to place thicker mesh graft on the wound that equals the burned area in size and whose quality is better. That way, the chances that the skin can rebuild the destroyed structures are a little greater.
MEDICA.de: How do patients cope having to live without any feeling in transplanted areas especially when it comes down to hands and feet?
Hartmann: If a hand or a foot burned completely the priority is not to restore sensation in the skin. The priority should be to restore functionality.
MEDICA.de: Sometimes heavy scars form. Then additional surgery is often necessary. Is it then possible to improve the tactile sense of the skin?
Hartmann: There are possibilities to improve the look of the burned skin parts through further surgeries by preventing heavy scarring. But there is no correlation between improved skin senses and the frequency of surgeries.
The interview was conducted by Kathrin Burghof MEDICA.de