Post burn flexion contractures are common in pediatric age group. Release of contracture and coverage with full thickness skin graft (FTSG) is a widely used procedure for this problem. This procedure is routinely done under tourniquet control because bloodless operative field is essential to visualize important neurovascular structures in hand. Use of tumescent technique without a tourniquet is gaining acceptance because it avoids complications associated with tourniquet use, maintains a blood less surgical field and decreases operative time. Furthermore use of tumescent anesthesia often results in better surgical outcomes. Although the benefits of tumescent technique used in wide awake hand surgery are well documented, epinephrine at a concentration of 1:1 000,00 has also been used as a replacement for pneumatic tourniquet for release of hand contracture in infants and adults under general anesthesia. Thus epinephrine 1:1,000,00 in saline solution can be a potential replacement for a tourniquet in hand surgeries done under general anesthesia.
Age range
3 Years – 12 Years
Sex
ALL
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Operative time to secure graft
Timeframe: Time of surgery
Percentage graft taken
Timeframe: 14th day post surgery
Post-operative pain (FLACC scale)
Timeframe: At First hour after arrival in ward following surgery
Post-operative pain (FLACC scale)
Timeframe: At 6th hour after arrival in ward following surgery
Post-operative pain (FLACC scale)
Timeframe: At 12th hour after arrival in ward following surgery
Post-operative pain (FLACC scale)
Timeframe: At 24th hour after arrival in ward following surgery