scholarly journals In search of ideal donor site wound dressings

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.

scholarly journals Effect of low level laser therapy on diabetic foot ulcers: a randomized control trial

2018 ◽  
Vol 5 (3) ◽  
pp. 1008 ◽  
Author(s):  
Lenifa Priyadarshini M. J. ◽  
Kishore Babu E. P. ◽  
Imran Thariq A.
Keyword(s):  
Wound Healing ◽  
Laser Therapy ◽  
Diabetic Foot ◽  
Skin Grafting ◽  
Low Level Laser Therapy ◽  
Level Laser ◽  
Split Skin Grafting ◽  
Secondary Procedures ◽  
Complete Wound Healing ◽  
Split Skin

Background: Nearly 15% of diabetic patients will suffer from DFU in their life span. Conventional treatment is not effective against the non-healing DFUs so in recent days so many adjuvant therapies which have been tried to stimulate healing process are in use. LLLT, is a non-invasive, pain-free method is considered as a possible treatment option for the diabetic foot syndrome. Aim of this study is to study the role of low level laser therapy on diabetic ulcers, i.e. Reduction in size of the ulcer, faster wound healing, control of infection, cost effectiveness and if secondary procedures like split skin grafting can be avoided.Methods: A total of 100 patients with Diabetic foot ulcer fitting the inclusion criteria was included in the study and they were randomly categorized into control and study group. Patients in the study group received treatment with LLLT. Ulcer bed with edge was irradiated locally with red light (660nm), about 4-8J/cm2 for 20 minutes was delivered for 15 days on daily basis. Conventional dressing was preferred for covering after irradiation and controls were treated with conventional therapy alone which includes dressings with betadine or wet with saline, Course of antibiotic treatment and sloughs removed whenever needed. The size, grade and culture status of the ulcer was assessed on Day 1 and day 15. Duration of stay in hospital was noted to assess cost effectiveness.Results: In LLLT group, after completing 15 days treatment complete wound healing was achieved in 66.6% of grade-1 ulcers and 4.4% of grade-2 ulcers and 96.6% of grade-2 ulcers improved to grade-1. In contrary only 3.4% of grade-2 ulcers improved to Grade 1 and a majority of ulcers remained as such. Reduction in Mean area of ulcer at day-15 was statistically significant in LLLT group (13.74±11.88 to 3.97±5.41cm2 and P<0.001) whereas reduction of mean ulcer area among controls was statistically not significant (19.09±15.03cm2 to 18.80±17.70cm2 and P=0.859). Mean total cost of the treatment was less compared to conventional treatment group. (2264.3±140 Vs 3588.4±68 Rs).Conclusions: Laser therapy is painless, cost effective procedure which induces faster granulation, wound contraction and reepithelialisation, thus accelerates complete wound healing hence avoiding secondary procedures like split skin grafting. Control of infection was also better compared to control group.

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

2013 ◽  
Vol 100 (5) ◽  
pp. 619-627 ◽  
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

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

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.

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

2008 ◽  
Vol 7 (2) ◽  
pp. 102-107 ◽  
Author(s):  
Uwe Wollina ◽  
Catherine Helm ◽  
Gesina Hansel ◽  
André Koch ◽  
Jaqueline Schönlebe ◽  
...  
Keyword(s):  
Skin Grafting ◽  
Cardiovascular Complications ◽  
Wound Management ◽  
Skin Infections ◽  
Diabetes Mellitus Type Ii ◽  
Split Skin Grafting ◽  
Ulcer Surgery ◽  
Causes Of Mortality ◽  
Split Skin

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.

scholarly journals Recent advances in topical wound care

2012 ◽  
Vol 45 (02) ◽  
pp. 379-387 ◽  
Author(s):  
Sujata Sarabahi
Keyword(s):  
Wound Healing ◽  
Chronic Wound ◽  
Wound Care ◽  
Skin Grafting ◽  
Primary Objective ◽  
Wound Management ◽  
Accelerate Wound Healing ◽  
Constant Change ◽  
Healing Wounds ◽  
Systemic Antibiotics

ABSTRACTThere are a wide variety of dressing techniques and materials available for management of both acute wounds and chronic non-healing wounds. The primary objective in both the cases is to achieve a healed closed wound. However, in a chronic wound the dressing may be required for preparing the wound bed for further operative procedures such as skin grafting. An ideal dressing material should not only accelerate wound healing but also reduce loss of protein, electrolytes and fluid from the wound, and help to minimize pain and infection. The present dictum is to promote the concept of moist wound healing. This is in sharp contrast to the earlier practice of exposure method of wound management wherein the wound was allowed to dry. It can be quite a challenge for any physician to choose an appropriate dressing material when faced with a wound. Since wound care is undergoing a constant change and new products are being introduced into the market frequently, one needs to keep abreast of their effect on wound healing. This article emphasizes on the importance of assessment of the wound bed, the amount of drainage, depth of damage, presence of infection and location of wound. These characteristics will help any clinician decide on which product to use and where,in order to get optimal wound healing. However, there are no ′magical dressings′. Dressings are one important aspect that promotes wound healing apart from treating the underlying cause and other supportive measures like nutrition and systemic antibiotics need to be given equal attention.

scholarly journals Modern approaches to the technical aspects of split-skin grafting

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.  

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

2020 ◽  
Vol 28 (1) ◽  
pp. 18
Author(s):  
Srikanth Vasudevan ◽  
SudarshanReddy Nagireddy ◽  
AshokBasur Chandrappa ◽  
YN Anantheshwar ◽  
Ritu Batth ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Prospective Study ◽  
Donor Site ◽  
Skin Grafting ◽  
Postoperative Pain Relief ◽  
Split Skin Grafting ◽  
A Prospective Study ◽  
Split Skin

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

2019 ◽  
Vol 6 (1) ◽  
pp. 25-33 ◽  
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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