A prospective study on efficacy of topical bupivacaine in split skin grafting donor site in immediate postoperative pain relief

Background: Post burn contracture is one of the most common problems in our country and usually seen in lower socio-economic people. Burn contractures of the neck can produce a signicant impact on quality of life by reducing a patient's ability to perform activities of daily living Methods: A prospective study was conducted with a sample size of 30 patients with post burn neck contracture conducted for a duration of 24 months. After meticulous surgical planning, patients underwent contracture release and split skin grafting/z-plasty followed by rigorous splintage and physiotherapy. Majority of the patients were in the age group of 11-30 years (63%).70% of the Results: patients sustained burns in the range of 21-40% and 80% were due to ame burns.46.66% (14) of patients had severe contracture while 13.33% (4) had extensive mento-sternal adhesions. 90% of the patients underwent release + SSG while 10% underwent z-plasty. Postoperatively cervico-mental angle of 100-120 degrees was achieved Skin grafting is a simple, reliable and safe operation however postoperative splinting is n Conclusion: ecessary. The use of skin grafts continues to deliver excellent results with adequate restoration of cervico-mental angle.

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Comparison of split skin thickness graft survival in diabetic and non-diabetic ulcer

International Surgery Journal ◽

10.18203/2349-2902.isj20201404 ◽

2020 ◽

Vol 7 (4) ◽

pp. 1238

Author(s):

Yamanur P. Lamani ◽

M. Amarnath Reddy ◽

E. B. Kalburgi ◽

B. S. Suhas

Keyword(s):

Wound Infection ◽

Graft Survival ◽

Revisional Surgery ◽

Donor Site ◽

Graft Infection ◽

Skin Grafting ◽

Diabetic Group ◽

Site Infection ◽

Split Skin Grafting ◽

Split Skin

Background: Split skin grafting is widely used surgical procedure for the treatment of ulcers. Graft survival depends on number of factors like vascularity, wound infection etc, diabetes is associated with endothelial dysfunction, neuropathy, wound infection which collectively affect the graft survival. Objective of this study was to compare the amount of graft uptake, the post-operative complications and survival of split thickness skin graft in diabetic and non-diabetic ulcer.Methods: In our prospective comparative study total 112 patients with ulcer were included of which 56 were diabetic and 56 were non-diabetic. All of t7hem underwent split skin grafting as part of their wound management. Comparison was made between two groups in terms of amount of graft uptake, post-operative wound infection, revisional surgery, donor site infection.Results: Compared with non-diabetics, diabetics have significantly less graft uptake (p<0.001). out of 56 patients in diabetic group 4 (66.7%) underwent revisional surgery, out of 56 patients in non-diabetic group 2 (33.3) patients underwent revisional surgery (p value is <0.68) which is statistically insignificant. 3 (60%) out of 56 in diabetic group developed post-operative graft infection, 2 (40%) out of 56 in non-diabetic group developed graft infection (p=1, not significant). One patient in the study developed donor site infection. Among 112 cases, only 1 case had donor site infection with diabetic.Conclusions: Diabetes is associated with poor graft uptake and post-operative complication rates in patients undergoing split skin grafting.

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Randomized clinical trial of donor-site wound dressings after split-skin grafting

British Journal of Surgery ◽

10.1002/bjs.9045 ◽

2013 ◽

Vol 100 (5) ◽

pp. 619-627 ◽

Cited By ~ 48

Author(s):

F. E. Brölmann ◽

A. M. Eskes ◽

J. C. Goslings ◽

F. B. Niessen ◽

R. de Bree ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Donor Site ◽

Skin Grafting ◽

Wound Dressings ◽

Split Skin Grafting ◽

Split Skin

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Lower extremity gangrene in children from traditional bone setters care: an avoidable cause of limb loss

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20202889 ◽

2020 ◽

Vol 8 (7) ◽

pp. 2524

Author(s):

Richard C. Echem ◽

Phillip D. Eyimina

Keyword(s):

Lower Extremity ◽

Skin Grafting ◽

Relevant Information ◽

Orthopaedic Practice ◽

Port Harcourt ◽

Split Skin Grafting ◽

Common Diagnosis ◽

A Prospective Study ◽

Split Skin ◽

The University

Background: Worldwide, lower extremity gangrene in children is rare. In orthopaedic practice in developing countries, a frequent cause of extremity gangrene is the practice of traditional bone setting. Aim of the study was to document lower extremity gangrene in children resulting from the care of traditional bone setters’ as seen in a tertiary health institution.Methods: A prospective study of children presenting with lower extremity gangrene from the care of traditional bone setters at the University of Port Harcourt Teaching Hospital from January 2006 to December 2018. Data obtained included the patients socio-demographics and relevant information related to the diagnosis. Data was analysed with SPSS version 20.Results: Eighteen children with lower extremity gangrene were seen. Their ages ranged from 10 days to 132 months. There was a female preponderance. Their parents mostly had primary and secondary levels of education and majority were married. The most common diagnosis was tibiofibular fractures followed by congenital clubfoot. Trauma-related injuries were mostly from falls. Duration before presentation ranged from 7 to 28 days. Majority had massage, splinting and bandaging from the bone setter. Most common associated complication at presentation was sepsis. All had provisional amputation. Most common amputation was below knee. Most had stump refashioning within 15 days. One had split skin grafting. There was one mortality. Duration of hospital stay ranged from 3 to 65 days.Conclusions: Children at any age can develop lower extremity gangrene from traditional bone setters’ care. This is an avoidable and preventable sequelae of care. Parental health education is necessary to discourage their patronizing traditional bone setters.

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How effective is ionic silver and chlorhexidine (SiO₂- Ag+ Chlorex) spray on pain and re-epithelialisation rate in donor site wounds for patients undergoing split skin grafting?

http://isrctn.com/ ◽

10.1186/isrctn58295774 ◽

2021 ◽

Author(s):

Hani Atiqah Saim

Keyword(s):

Donor Site ◽

Skin Grafting ◽

Ionic Silver ◽

Split Skin Grafting ◽

Split Skin

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Dosed tissue stretching in the preparation of the donor site for chronic wounds split-skin grafting

Wounds and wound infections The prof B M Kostyuchenok journal ◽

10.25199/2408-9613-2018-6-1-25-33 ◽

2019 ◽

Vol 6 (1) ◽

pp. 25-33 ◽

Cited By ~ 1

Author(s):

I. V. Pavlenko ◽

V. V. Beschastnov ◽

M. G. Ryabkov

Keyword(s):

Skin Graft ◽

Traditional Method ◽

Donor Site ◽

Skin Grafting ◽

Main Group ◽

Male Rats ◽

Control Group ◽

Results Of Treatment ◽

Split Skin Grafting ◽

Split Skin

Objective. Development of a new method for preparing an skin graft to hypoxia conditions in a recipient wound by tissue stretching of the donor site.Materials and methods. Scientific hypothesis: dosed tissue stretching and localized circulatory compensated hypoxia resulting in this increase the concentration of cytokine HIF-1α in the area of distracted skin graft. The experiment was performed on 18 white outbred male rats. The level of local circulatory compensated hypoxia was monitored by using laser Doppler flowmetry. An enzyme immunoassay was used to determine the concentration of cytokine HIF-1α in tissue. In the clinical stage of the study, the results of treatment in 9 patients – main group (split-skin grafting developed by the original method) were compared with the results of treatment in 10 patients – control group, who underwent plastic closure according to the traditional method.Results.The experiment revealed a statistically significant difference between the concentration of cytokine HIF-1α in the intact and disractablegraft, which was confirmed by the results of a clinical study.In the group where split-skin grafting was performed according to the traditional method (control group), the graft engraftment area was (Me [Q1; Q3]) 71.0 [65; 78] %, in the main group – (Me [Q1; Q3]) 87.0 [79; 95] % (p = 0.0003).Conclusion. It is advisable to use a compensated reduction of microcirculation in a tissue subjected to dosed tissue stretching to train split-skin graft for hypoxia conditions.

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In search of ideal donor site wound dressings

International Surgery Journal ◽

10.18203/2349-2902.isj20203786 ◽

2020 ◽

Vol 7 (9) ◽

pp. 3012

Author(s):

Dev Jyoti Sharma ◽

Bharat Mishra ◽

Chetna Arora

Keyword(s):

Wound Healing ◽

Donor Site ◽

Skin Grafting ◽

Healing Time ◽

Primary Objective ◽

Wound Dressings ◽

Wound Management ◽

Split Skin Grafting ◽

Complete Wound Healing ◽

Split Skin

Background: Split skin grafting (SSG) is a commonly used reconstructive technique for wound cover. Donor site wounds (DSW) after split-skin graft harvesting are rather clean wounds. Depending on the thickness of the SSG, the DSW should re-epithelialize completely in 7 to 21 days. This study was initiated with a background to look for an ideal dressing for the management of DSW. Aim of the study was to compare efficacy of Cellulose acetate mesh, Collagen sheet, Hydrocolloid dressings and chlorhexidine tulle for donor site wound management after harvesting split thickness skin graft.Methods: 100 patients with 100 donor site wounds were included in the study. Patients were randomized into four different groups of 25 each, depending upon the type of dressings used to cover the wound. Data regarding time to complete wound healing and pain at the donor site were recorded on visual analogue scale (VAS). Requirement of pain killers during post-operative period were recorded. Complications like infection or hyper-granulation were also recorded.Results: The study included 72 males and 28 females. The primary objective was to observe the effectiveness of wound dressings in the treatment of DSWs and time to complete wound healing. In this context, collagen dressing was found to be the most effective in current study (p<0.07) and also the least pain was experienced by the patients where collagen dressings were used.Conclusions: The study concluded that collagen dressings was best amongst the various dressings studied with average healing time of 9 days with least pain score over DSW.

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