scholarly journals A retrospective study of comparison of collagen dressing versus conventional dressing for skin graft donor site

2021 ◽  
Author(s):  
Tushar J. Dave ◽  
Shashirekha C. A. ◽  
Krishnaprasad K.
Keyword(s):  
Retrospective Study ◽  
Pain Score ◽  
Donor Site ◽  
Skin Grafting ◽  
Collagen Group ◽  
Scar Assessment ◽  
Split Skin Grafting ◽  
Split Thickness Skin Grafting ◽  
Significant Difference ◽  
Scar Score

Background: Split-skin grafting is commonly employed for covering skin defects in case of ulcers, deep burns and following trauma. It involves harvesting of the epidermis and upper 1/3rd of dermis resulting in a wound called donor site wound (DSW). These wounds pose a kind of burden to patients during the process and after the process of wound healing. These wounds tend to cause pain, are at risk of getting infected, pruritis and cosmetic inconvenience. DSW has been managed with closed or open dressings. Out of many methods, we aim to compare the efficacy of collagen dressing with that of conventional dressing in this study.Methods: A retrospective study including 30 subjects were stratified into 2 groups; group A-collagen dressing and group B- conventional dressing. Patients aged between 18 to 60 years undergoing split thickness skin grafting were included. Patients who are immunocompromised, diabetic, with underlying skin disease and infected wounds were excluded. The outcome was compared in terms of pain, pruritis and scar assessment using Vancouver scar scale.Results: In the present study there was significant difference in median pain score, pruritus and median Vancouver scar score in collagen group compared to conventional group at all the intervals. Also, the incidence of surgical site infection was lower in the collagen dressing group.Conclusions: Collagen dressing is superior compared to conventional dressing in terms of lower pain score, pruritus score and Vancouver scar score. 

scholarly journals The scalp as a donor site for skin grafting in burns: retrospective study on complications

2016 ◽  
Vol 4 ◽  
pp. 1-6 ◽  
Author(s):  
Dorota Teresa Roodbergen ◽  
Adrianus Fredericus Petrus Maria Vloemans ◽  
Zjir Mezjda Rashaan ◽  
Jacob Cornelis Broertjes ◽  
Roelf Simon Breederveld
Keyword(s):  
Retrospective Study ◽  
Surface Area ◽  
Complication Rate ◽  
Donor Site ◽  
Total Body Surface Area ◽  
Skin Grafting ◽  
Healing Time ◽  
Late Complications ◽  
Split Skin Grafting ◽  
Total Body

Abstract Background Split skin grafting (SSG) is the cornerstone in the treatment of deep burns and large skin defects. Frequently used donor sites are the thigh, abdomen and buttocks. The scalp is less common while considered as a reliable donor site. Advantages are a large surface area, rapid wound healing, cosmetically favourable results and multiple harvests from the same donor site. Complications include scab formation, chronic folliculitis and alopecia but have been recorded sporadically in previous studies. This article evaluates the complication rate of the scalp donor site in the treatment of deep burns in the Beverwijk Burn Centre. Methods A retrospective study was performed of all patients who received a skin graft from the scalp at the Beverwijk Burn Centre between January 2004 and December 2012. Data were collected from medical files of included patients, including gender, age, type of burn (scald, flame, other) and total body surface area (TBSA) burned at the time of first surgery. Postoperative variables were healing time of the donor site and incidence of complications. During follow-up, the incidence of late complications was reviewed. Results A total number of 105 grafts were analysed in 93 patients: 58 males (62 %) and 35 females (38 %), with a median age of 2 years and 3 months old. Of the patients, 30 (32 %) had flame burns and 57 (61 %) had scald burns. Eighty-seven percent of patients had a TBSA burned of 5 % or less. All donor sites healed within 14 days. No alopecia or scar hypertrophy developed at the donor sites. Two patients (2.2 %) developed folliculitis; one patient (1.1 %) showed scab formation. Conclusions The scalp as a donor site in our Burn Centre shows a comparable short-term complication rate to the previous literature, with quick healing and no long-term complications. Therefore, we propose the consideration of the scalp as a primary donor site, especially in young children, where the scalp offers a larger donor site area than the buttocks or thighs.

scholarly journals Regrafting of the Split-Thickness Skin Graft Donor-Site: Is It Beneficial?

2019 ◽  
Author(s):  
Catherine M Legemate ◽  
Ymke Lucas ◽  
Irma M M H Oen ◽  
Cornelis H Van Der Vlies
Keyword(s):  
Skin Graft ◽  
Donor Site ◽  
Skin Grafting ◽  
Split Thickness Skin Graft ◽  
Split Skin Graft ◽  
Thickness Skin ◽  
Split Skin Grafting ◽  
Split Thickness Skin Grafting ◽  
Graft Donor ◽  
Split Skin

Abstract Split-thickness skin grafting remains a fundamental treatment for patients with deep burns and other traumatic injuries. Unfortunately, the donor site wound that remains after split skin graft (SSG) harvesting may also cause problems for the patient; they can lead to discomfort and scars with a poor cosmetic outcome. Regrafting of the donor site is one of the methods described to improve donor site healing and scarring. In this report, we describe a case of a 26-year-old woman with a self-inflicted chemical burn (0.5% TBSA) who underwent split skin grafting. During surgery, only part of the donor site was regrafted with split skin graft remnants. This part healed faster and had a better scar quality at 3 months postsurgery. Nevertheless, the appearance and patients’ opinion on the regrafted part deteriorated after 12 months. With this case report, we aim to create awareness of the long-term consequences of regrafting, which may differ from short-time results. Patients expected to have poor reepithelialization potential may benefit from regrafting of the SSG on the donor site. But in healthy young individuals, timewise there would be no benefit since it can lead to an aesthetically displeasing result.

scholarly journals A cross-sectional study of long-term satisfaction after surgery for congenital syndactyly: does skin grafting influence satisfaction?

2018 ◽  
Vol 44 (3) ◽  
pp. 296-303 ◽  
Author(s):  
Bien R. Ferrari ◽  
Paul M.N. Werker
Keyword(s):  
Donor Site ◽  
Skin Grafting ◽  
Cross Sectional Study ◽  
Complication Rates ◽  
Skin Grafts ◽  
Sectional Study ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Scar Assessment

Syndactyly correction without skin grafting is advocated because it prevents graft-related complications and donor site morbidity. In this cross-sectional study, we compared satisfaction among patients who underwent correction with and without skin grafting to determine preference based on subjective and objective parameters. Retrospective chart analysis was performed among 27 patients (49 webs) who were seen at follow-up after a median follow-up period of 7.4 years, at which the Patient and Observer Scar Assessment Scale, the Withey score and a satisfaction survey were used. Notably, there were no significant differences in complication rates or observer rated scar scores. Although the need for an additional surgical procedure was higher after skin grafting, patient-rated satisfaction scores were similar irrespective of the use of grafting. Our data suggest that corrections can best be performed without skin grafts if seeking to minimize the need for an additional procedure, but that the use of skin grafts does not appear to affect patient satisfaction. Level of evidence: IV

scholarly journals Dental impression compound as an effective splint for maintenance of ear elevation in microtia reconstruction

2013 ◽  
Vol 46 (03) ◽  
pp. 518-520 ◽  
Author(s):  
Padam Singh Bhandari ◽  
Sukhbir Singh
Keyword(s):  
Retrospective Study ◽  
Skin Grafting ◽  
Important Goal ◽  
Post Surgery ◽  
Post Procedure ◽  
Split Skin Grafting ◽  
Dental Impression ◽  
Split Skin ◽  
Staged Reconstruction

ABSTRACTEar projection is an important goal to be achieved after stage two (ear elevation) in cases of microtia. This is a retrospective study conducted on patients with microtia who underwent staged reconstruction for the same. This study has been carried out over a period of 10 years with 211 patients. Dental impression compound was used as a splint after ear elevation and split skin grafting to maintain the projection of the ear. Projection of the ear was measured both pre- and post-procedure and at every follow-up using goniometer and photographic documentation was simultaneously done. Statistical analysis was performed using t-test. Patients were reviewed every month and splint was continued until 6 months post-surgery. The splint was very effective in maintaining the ear projection of more than 20° even after prolonged follow-up of upto 2 years. There were no complications associated with the splint application or prolonged use.

Minced skin grafting for promoting epithelialization of the donor site after split-thickness skin grafting

Burns ◽  
2017 ◽  
Vol 43 (4) ◽  
pp. 819-823 ◽  
Author(s):  
Toru Miyanaga ◽  
Yasuo Haseda ◽  
Akihiko Sakagami
Keyword(s):  
Donor Site ◽  
Skin Grafting ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

scholarly journals A systematic review of the scalp donor site for split-thickness skin grafting

2020 ◽  
Vol 47 (6) ◽  
pp. 528-534
Author(s):  
Suk Joon Oh
Keyword(s):  
Donor Site ◽  
Age Distribution ◽  
Total Body Surface Area ◽  
Skin Grafting ◽  
Late Complications ◽  
Total Rate ◽  
Thickness Skin ◽  
Pubmed Database ◽  
Split Thickness Skin Grafting ◽  
Scalp Skin

Split-thickness skin grafting (STSG) is the gold standard for coverage of acute burns and reconstructive wounds. However, the choice of the donor site for STSG varies among surgeons, and the scalp represents a relatively under-utilized donor site. Understanding the validity of potential risks will assist in optimizing wound management. A comprehensive literature search was conducted of the PubMed database to identify studies evaluating scalp skin grafting in human subjects published between January 1, 1964 and December 31, 2019. Data were collected on early and late complications at the scalp donor site. In total, 27 articles comparing scalp donor site complications were included. The selected studies included analyses of acute burn patients only (21 of 27 articles), mean total body surface area (20 of 27), age distribution (22 of 27), sex (12 of 27), ethnicity (5 of 27), tumescent technique (21 of 27), depth setting of the dermatome (24 of 27), number of harvests (20 of 27), mean days of epithelization (18 of 27), and early and late complications (27 of 27). The total rate of early complications was 3.82% (117 of 3,062 patients). The total rate of late complications was 5.19% (159 of 3,062 patients). The literature on scalp skin grafting has not yet identified an ideal surgical technique for preventing donor site complications. Although scalp skin grafting provided superior outcomes with fewer donor site complications, there continues to be a lack of standardization. The use of scalp donor sites for STSG can prevent early and late complications if proper surgical planning, procedures, and postoperative care are performed.

scholarly journals Long-term experience with a collagen-elastin scaffold in combination with split-thickness skin grafts for the treatment of full-thickness soft tissue defects: improvements in outcome—a retrospective cohort study and case report

2021 ◽  
Author(s):  
Maximilian Lempert ◽  
Sascha Halvachizadeh ◽  
Clara Charlotte Salfelder ◽  
Valentin Neuhaus ◽  
Hans-Christoph Pape ◽  
...  
Keyword(s):  
Cohort Study ◽  
Soft Tissue ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Skin Grafting ◽  
Full Thickness ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Significant Difference ◽  
The Impact

Abstract Purpose The management of severe soft tissue injuries to the extremities with full-thickness wounds poses a challenge to the patient and surgeon. Dermal substitutes are used increasingly in these defects. The aim of this study was to investigate the impact of the type of injury on the success rate of Matriderm® (MD)-augmented split-thickness skin grafting, as well as the role of negative pressure wound therapy (NPWT) in preconditioning of the wounds, with a special focus on the reduction of the bioburden. Methods In this study, 45 wounds (44 affecting lower extremities (97.7%)), resulting from different types of injuries: soft tissue (ST), soft tissue complications from closed fracture (F), and open fracture (OF) in 43 patients (age 55.0 ± 18.2 years, 46.7% female), were treated with the simultaneous application of MD and split-thickness skin grafting. The study was designed as a retrospective cohort study from March 2013 to March 2020. Patients were stratified into three groups: ST, F, and OF. Outcome variables were defined as the recurrence of treated wound defects, which required revision surgery, and the reduction of bioburden in terms of reduction of number of different bacterial strains. For statistical analysis, Student’s t-test, analysis of variance (ANOVA), Mann–Whitney U test, and Pearson’s chi-squared test were used. Results There was no significant difference in the rate of recurrence in the different groups (F: 0%; OF: 11.1%; ST: 9.5%). The duration of VAC therapy significantly differed between the groups (F: 10.8 days; OF: 22.7 days; ST: 12.6 days (p < 0.05)). A clinically significant reduction of bioburden was achieved with NPWT (bacterial shift (mean (SD), F: − 2.25 (1.89); OF: − 1.9 (1.37); ST: − 2.6 (2.2)). Conclusion MD-augmented split-thickness skin grafting is an appropriate treatment option for full-thickness wounds with take rates of about 90%. The complexity of an injury significantly impacts the duration of the soft tissue treatment but does not have an influence on the take rate. NPWT leads to a relevant reduction of bioburden and is therefore an important part in the preconditioning of full-thickness wounds.

Ultrasound-guided Fascia Iliaca Plane Block for the treatment of donor site pain in the burn injured patient: a randomized control trial

2021 ◽  
Author(s):  
C Town ◽  
H Strand ◽  
J Johnson ◽  
J Brown ◽  
A Pelecanos ◽  
...  
Keyword(s):  
Pain Score ◽  
Donor Site ◽  
Intervention Group ◽  
Skin Grafting ◽  
Control Group ◽  
Postoperative Phase ◽  
Ultrasound Guided ◽  
Post Surgery ◽  
Pain Scores ◽  
Donor Site Pain

Abstract Burn injuries requiring surgical intervention often result in split- thickness skin grafting procedures, with donor skin frequently harvested from the patient’s anterolateral thigh. The donor site is often reported as the primary site of post-operative pain due to the damage sustained to localised nociceptors.A randomised control trial was undertaken to evaluate the impact an ultrasound-guided regional nerve block would have on patient reported pain scores in donor site wounds, and associated rescue analgesia consumption. Twenty participants requiring split-skin grafting for burn injuries of &lt;15% total body surface area were enrolled from a tertiary burns unit and randomised to control (10 participants) or intervention group (10 participants). The intervention group received the addition of an ultrasound-guided facia iliaca plane block prior to their surgery. Primary outcome was pain score in the donor site during the postoperative phase; while secondary outcome was pain on day 1 post-surgery as measured by the numeric pain score (0-10). During the post-operative phase, the intervention group had a significantly lower median donor site pain score of 0 (interquartile range (IQR) 0 - 0), compared to the control group median 6 (IQR 4 - 7) (p &lt; 0.001). Day 1 post-surgery the intervention group had a median pain score of 0 (IQR 0 – 4) compared to control group median 4.5 (IQR 2 – 6) (p= 0.043).The study findings demonstrated that regional anaesthesia was an effective way to reduce pain scores and requirement for additional analgesics during the postoperative phase.

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