An approach to curative effect of large autografts on adipose tissue in special parts with third-degree burns.

Burns involving face, hand, dorsum of foot and areas around joints are regarded as burns of special parts. Because of the structural characteristics we emphasize the importance of preserving subeschar adipose tissue and using large sheets of skin graft in these parts of body during the resurfacing procedures. Thirty-one cases with 56 sites of deep burns were observed. The results were good. Followup in three typical cases is reported in detail in this article. Preserving subeschar healthy fatty tissue can ensure high graft take rate, early functional recovery, and immediate as well as long-range curative effect. So one must carefully judge the cutting depth of eschar excision. We prefer grafting debrided facial wounds with sheets of skin according to regional units. The minimal width of circular grafts around ankle and wrist is discussed. For wrist, the recommended minimal width is 4 cm; for ankle, it is 5 cm.