Deep Ulcer Shaving Combined With Split-Skin Transplantation in Distal Calciphylaxis

Calciphylaxis is a cause of painful deep ulcers. There is controversy about best wound management in this disease. A retrospective study of inpatients during the 3 years was made. Seven calciphylaxis patients were identified. All patients suffered from various associated pathologies including diabetes mellitus type II and chronic renal insufficiency. Ulcers were treated by aggressive and deep shaving combined with autologous split-skin grafting in the same session. A 30% to 90% take rate of the grafts eventually with a complete ulcer healing in 6 of 7 patients was achieved. No patient developed a deep cutaneous infection or sepsis. All patients are still alive except one. The single death was related to cardiovascular complications. In distal calciphylaxis, aggressive ulcer surgery with defect closure offers a marked improvement in quality of life and prevents early deep skin infections and sepsis as major causes of mortality.

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MANAGEMENT OF POST BURN CONTRACTURE OF NECK IN A TERTIARY BURN CARE CENTRE

10.36106/ijsr/2601210 ◽

2021 ◽

pp. 33-35

Author(s):

Nangineedi Nagaprasad ◽

Karthik G B

Keyword(s):

Surgical Planning ◽

Skin Grafting ◽

Burn Care ◽

Split Skin Grafting ◽

Contracture Release ◽

Common Problems ◽

A Prospective Study ◽

Split Skin ◽

Burn Contractures

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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Patient-reported scar quality of donor-sites following split-skin grafting in burn patients: Long-term results of a prospective cohort study

Burns ◽

10.1016/j.burns.2020.12.005 ◽

2020 ◽

Author(s):

Catherine M. Legemate ◽

Pauline J. Ooms ◽

Nicole Trommel ◽

Esther Middelkoop ◽

Margriet E. van Baar ◽

...

Keyword(s):

Cohort Study ◽

Skin Grafting ◽

Long Term Results ◽

Burn Patients ◽

Split Skin Grafting ◽

Patient Reported ◽

Scar Quality ◽

Split Skin

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Modern approaches to the technical aspects of split-skin grafting

Vestnik of Experimental and Clinical Surgery ◽

10.18499/2070-478x-2018-11-1-59-69 ◽

2018 ◽

Vol 11 (1) ◽

pp. 59-69

Author(s):

Vladimir Viktorovich Beschastnov ◽

Ilya Viktorovich Pavlenko ◽

Maksim Vladimirovich Bagryantsev ◽

Vladimir Vladimirovich Kichin ◽

Peter Vladimirovich Peretyagin ◽

...

Keyword(s):

Soft Tissue ◽

Bacterial Contamination ◽

Surgical Techniques ◽

Skin Grafting ◽

Wound Management ◽

Successful Outcome ◽

Blood Protein ◽

Total Blood ◽

Split Skin Grafting ◽

Split Skin

Split-skin grafting takes the leading place when closing extensive soft tissue defects. Such defects can be the result of both an acute process (pyoinflammatory soft tissue diseases, surgical interventions) and chronic disorders in the skin and underlying tissues (trophic ulcers of venous and arterial genesis, fistulas, decubitus, complications of the diabetic foot syndrome). The main criterion for assessing the result of split-skin grafting is the percentage of engraftment of the skin graft. There are several classifications that characterize the degree of closure of the recipient wound (Petrova VI, Rysmana BV, Gostishcheva VK). According to most authors, the successful outcome of split-skin grafting depends on several groups of factors. Systemic factors include the content of the total blood protein, hemoglobin, which should not be below acceptable standards. To the local - the readiness of the recipient wound to skin plasty. Microcirculation in the recipient bed plays an important role. The opinions of the researchers about the bacterial contamination of the wound and its effect on the processes of engrafting the flap are opposite. Some believe that a good engraftment of an autodermotransplant is possible even in the presence of a wounded pathogenic microflora in the wound. In modern works the negative influence of microorganisms on the results of split-skin grafting has been proved. Moreover, the upper limit of bacterial contamination of wounds is determined, the excess of which inevitably leads to unsatisfactory results of the transplantation of the skin. The method of postoperative donor wound management is a separate issue in plastic and reconstructive surgery. The review examines the criteria for the readiness of a wound for split-skin grafting, various types of preparation of the wound bed for plastic closure, surgical techniques for performing split-skin grafting, and options for closing the donor wound.

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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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