scholarly journals Surgical Outcome in Tumescent and Non-Tumescent Method of Harvesting Split Skin Graft - An Observational Study at KR Hospital, Mysuru

2021 ◽  
Vol 8 (26) ◽  
pp. 2322-2327
Author(s):  
Anandaravi B.N. ◽  
Manjunath R.D. ◽  
Puneeth D.N
Keyword(s):  
Observational Study ◽  
Skin Graft ◽  
Local Anaesthesia ◽  
Split Skin Graft ◽  
Tumescent Technique ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Group A ◽  
Group B ◽  
Split Skin

BACKGROUND The study was started with the aim to determine take up rate in tumescent technique compared to non-tumescent technique for harvesting split skin graft. Tumescent technique has been practiced for over forty years especially in liposuction. Tumescent anaesthesia is a combination of crystalloid, lignocaine, adrenaline and sodium bicarbonate. Using tumescent local anaesthesia for harvesting a split thickness skin graft is not in much practise. This study was designed to provide strong evidence of this technique. METHODS This was an observational study. Two treatment groups of patients, tumescent (group A, N = 21) and non-tumescent technique (group B, N =21), who fulfilled the inclusion criteria were randomly assigned. Tumescent technique involved administration of Klein’s formula. No prior administration of agent was performed in non-tumescent technique. The recipient site was opened in both groups on the fifth day after surgery and take rate assessed. RESULTS The difference in take up rate between the two groups was found to be statistically significant. Compared to the patients in group B, patients who underwent tumescent technique (group A) had higher take up rate (> 12 %, P = 0.005). We did not find any statistically significant difference in donor site percentage healing between the tumescent and non-tumescent groups, P = 0.379. CONCLUSIONS Tumescent technique gives better take up results and is more effective than nontumescent technique in harvesting split skin graft. The subdermal injection creates a smooth, dense surface which assists donor harvesting. This can be implemented preoperatively in split-thickness skin grafting. KEYWORDS Split Skin Graft, Take Up Rate, Harvesting, Tumescent, Non-Tumescent, Local Anaesthesia

scholarly journals Tumescent versus non-tumescent technique in skin graft healing: a cross-sectional study

2018 ◽  
Vol 5 (5) ◽  
pp. 1822
Author(s):  
Ramesh Koujalagi ◽  
V. M. Uppin ◽  
Rajesh Pawar ◽  
Vaibhav Avinash Patil
Keyword(s):  
Blood Loss ◽  
Skin Graft ◽  
Healing Rate ◽  
Donor Site ◽  
Skin Grafting ◽  
Tumescent Technique ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Group A ◽  
Group B

Background: Skin grafting, especially burn surgery, is associated with great blood loss. Tumescent technique is the subdermal injection of fluid containing a vasoconstrictor prior to burn wound surgery to reduce blood loss. Adrenaline is used to harvest skin grafts due to its vasoconstriction effect which limits blood loss. Although adrenaline is widely used, its local and systemic effects vary from patient to patient. The object of the present study was to observe the efficacy of tumescent technique, using adrenaline, versus non-tumescent technique in the healing of split thickness skin graft donor day 10.Methods: Two treatment groups of patients, tumescent (group A, n = 45) and non-tumescent technique (group B, n = 45), who fulfilled the inclusion criteria were randomly assigned. Tumescent technique involved administration of 1 mg (1:1000) adrenaline in 500 mL of saline. No prior administration of agent was performed in non-tumescent technique. Split-thickness skin grafting was carried out followed by regular inspection of the donor site. Healing rate was recorded at the postoperative day 10 by performing wound tracing technique and evaluated by performing unpaired t-test. P <0.05 was considered as statistically significant. Results: The mean age of patients was 29.98±12.6 years in group A and 45.36±10.23 years in group B. Age distribution was concentrated between 18 and 38 years. On postoperative day 10, complete epithelialization was observed in 15.56 % and 6.66% of patients in group A and B, respectively. Compared to the patients in group B, patients who underwent tumescent technique (group A) had higher healing rate (>80%, p=0.0134). Evidence of infection in the donor site was absent in both the groups.Conclusions: Tumescent technique by using adrenaline is more effective than non-tumescent technique in the healing of donor site and can be implemented preoperatively in split-thickness skin grafting.

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 Use of a hypogastric flap and split-thickness skin grafting for a degloving injury of the penis and scrotum: A different approach

2009 ◽  
Vol 42 (02) ◽  
pp. 258-260
Author(s):  
S. Sengathir Selvan ◽  
Ganesh S. Alagu ◽  
R. Gunasekaran
Keyword(s):  
Skin Grafting ◽  
Scrotal Skin ◽  
Split Skin Graft ◽  
Aesthetic Result ◽  
Degloving Injury ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Newly Married ◽  
Split Skin ◽  
Agricultural Machines

ABSTRACTPenile and scrotal skin avulsions are not common events and are caused usually by accidents with industrial machines or agricultural machines. We report a case of a 27-year-old newly married thin-built patient with avulsion and traumatic degloving of the penile and scrotal skin, with exposure of the corpora cavernosa and copus spongiosum of penis and testes as his loose clothes got entangled in a paddy harvesting machine accidently. Reconstruction was performed using a hypogastric flap and split skin graft, achieving a satisfactory aesthetic result and sexual functions.

scholarly journals Comparison of the effectiveness of Ropivacaine soaked vs bupivacaine soaked dressing for pain relief at split thickness skin graft donor site.

2020 ◽  
Vol 27 (09) ◽  
pp. 1952-1957
Author(s):  
Abdul Malik Mujahid ◽  
Farrukh Aslam Khalid ◽  
Kashif Mehmood Sheikh ◽  
Muhammad Sheraz Raza ◽  
Husnain Khan ◽  
...  
Keyword(s):  
Pain Relief ◽  
Rating Scale ◽  
Donor Site ◽  
Skin Grafting ◽  
Tissue Loss ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Group A ◽  
The Mean ◽  
Group B

Objectives: To compare the mean pain score of ropivacaine soaked dressing versus bupivacaine-soaked dressing for pain relief at the donor site among patients requiring split thickness skin grafting after burns and tissue loss. Study Design: (RCT) Randomized control trial. Setting: Department of Plastic Surgery Jinnah Burn and Reconstructive Surgery Center Lahore. Period: January 1, 2019 to June 31, 2019. Material & Methods: Total 120 patients meeting the inclusion criteria were enrolled and divided randomly into Group-A and Group-B based on lottery method. Group A was dressed with ropivacaine soaked dressing while group-B with bupivacaine-soaked dressing. Patients were asked about pain four hours after the dressing using the verbal rating scale of 0-10. Result: Total 120 patients were included and randomly divided in to two groups. The mean age of ropivacaine group (Group A) patients was 40.82±13.20 years and bupivacaine group (Group-B) patients was 39.70±12.20 years. 56(46.67%) patients were males and 64(53.33%) patients were females.  Male to female ratio was 0.8:1. The mean size of the defect for Group-A patients was 10.43±2.92 and Group B patients was 10.13±2.91. The Mean Visual Rating Scale (VRS) at the baseline for ropivacaine was 7.95 ± 1.04 and for bupivacaine was 8.0167 ±.791 (p =0.695) and VRS (verbal rating scale) at 4 hours of ropivacaine group patients was 1.27±1.13 and in bupivacaine group patients was 2.58±1.61. The statistically significant difference is found between the two study groups for VRS at 4 hours (p-value=0.001). Conclusion: Ropivacaine soaked dressing showed significantly better outcome than bupivacaine-soaked dressing at the donor site among patients requiring split thickness skin grafting after burns and tissue loss.

TOTAL PENILE DEGLOVING INJURY RESURFACED WITH A SPLIT SKIN GRAFT – A CASE REPORT

2021 ◽  
pp. 40-41
Author(s):  
Surya Rao Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj ◽  
Narayanamurthy Sundaramurthy ◽  
Anand Prasath Jayachandiran ◽  
Suresh Rajendran
Keyword(s):  
Skin Graft ◽  
Split Skin Graft ◽  
Full Thickness Skin Graft ◽  
Erectile Tissue ◽  
Degloving Injury ◽  
Thickness Skin ◽  
Free Skin Graft ◽  
Degloving Injuries ◽  
Thorough Debridement ◽  
Split Skin

Degloving injuries of the penis are a rare occurrence often requiring reconstruction. They are usually caused by industrial or agricultural machinery and tend to involve both the penile shaft and the scrotal skin with young adults being the usual victims. A penile degloving usually begins just proximal of the coronal line and progress down to the base of the shaft. Deep erectile tissue and the spermatic cord are usually undamaged and the endogenous skin of glans usually survives. The management requires thorough debridement and resurfacing the raw area by either using the degloved skin as a ap or a free skin graft, or by using a split skin or a full thickness skin graft. Here, we report a case of a total penile skin degloving managed with a split skin graft with satisfactory cosmetic result.

The Split Skin Graft Donor Site: Can Pretreatment with Vitamin a Cream Help?

2002 ◽  
Vol 10 (2) ◽  
pp. 78-80
Author(s):  
Pj Skoll ◽  
M Soldin ◽  
M Grob ◽  
B Seymour ◽  
J Davies ◽  
...  
Keyword(s):  
Vitamin A ◽  
Skin Graft ◽  
Donor Site ◽  
Skin Grafting ◽  
Hot Water ◽  
Split Skin Graft ◽  
Clinical Criteria ◽  
Split Thickness Skin Grafting ◽  
Graft Donor ◽  
Split Skin

Background A skin graft donor site that heals rapidly with less cosmetic sequelae is of particular benefit to children with burns. Vitamin A cream has been shown to speed up healing after controlled ‘burns’ (dermabrasion and CO2 laser) if it is applied six weeks before treatment. Objective To assess whether pretreatment with vitamin A cream increases the rate of healing of split skin graft donor sites in children with burns. Methods Prospective study of children with hot water burns of 8% to 30% that required split thickness skin grafting. Vitamin A cream was applied bidaily to one thigh and/or buttock of each child for five to seven days before skin grafting. At surgery, equal thickness grafts were harvested from both thighs and/or buttocks. Biopsies were taken from each thigh and/or buttock and were sent for histological analysis. The rate of donor site healing was monitored clinically and with serial photographs. Results No difference in the rate of healing was noted between the treated and untreated sides by either histological or clinical criteria. Conclusions Vitamin A cream applied bidaily for a period of five to seven days did not affect the healing rate of the split skin graft donor sites in children with burns.

scholarly journals Outcome of Skin Graft in Postburn Finger Contractures: An Integrated Technique of Evaluation

1970 ◽  
Vol 27 (1) ◽  
pp. 25-29
Author(s):  
Ali Ayub ◽  
Shafquat H Khundkar
Keyword(s):  
Skin Graft ◽  
Split Thickness Skin Graft ◽  
Full Thickness ◽  
Full Thickness Skin Graft ◽  
Extension Deficit ◽  
Full Thickness Skin ◽  
Graft Take ◽  
Thickness Skin ◽  
Group A ◽  
Group B

Objective: This prospective clinical study was conducted between July 2003- June 2005 at Dhaka Medical College Hospital, Dhaka, Bangladesh to make a comparative evaluation of the outcome of skin graft on patients of postburn contractures of the fingers using integrated scores for measuring several outcomes together. Materials & Methods: A total of 56 subjects of postburn contractures of the fingers were selected consecutively and were evaluated at baseline by number of digits affected, surface area involved, extension deficit, fingers with maximum extension deficit and duration of contracture. Thirty two subjects were assigned to Full-thickness skin graft group (Group-A) and 24 to Split-thickness skin graft group (Group-B). Respective graft coverage was applied to the wound following release of contracture. Immediate outcome was evaluated in terms of graft take and number of graft-site complications, while follow up outcome was evaluated in terms of extension deficit six months after correction using specific scores for defined outcome. Results: Over 70% of the subjects were < 15 years with mean ages of Group-A and Group-B were 9.38 ± 1.66 and 9.94 ± 1.42 years respectively. In both groups maximum extension deficit was found in little finger (78% in Group- A and 54% in Group-B). The Interphalangeal (IP) joints were observed to be most frequently involved (78% in Group-A and 75% in Group-B). The duration of contracture, number of digits involved and surface area of the fingers involved were almost identically distributed between the groups. Outcome shows that donor-site morbidities (discolouration and hypertrophic scars) were significantly less in Group-A compared to that in Group- B (p < 0.001 and p = 0.047). Similarly the Group-A was significantly superior compared to Group-B in terms of minimal extension deficit (0 - 10°) 6 months after correction (59.4% vs. 25%, P < 0.05). About two-third of the subjects in both the groups demonstrated 100% graft take and around 80% had 2 or < 2 graft-site morbidities. The excellent outcome was significantly higher in Group- A (37.5%) than that in Group-B (12.5%) (p < 0.05). Conclusion: Full-thickness skin graft is a better option of intervention than Split-thickness skin graft for coverage after release of contracture. However, the findings need to he validated by a larger sample size. Key words: Postburn flexion deformity, full-thickness skin graft, split-thickness skin graft, graft take, donor-site morbidity, graft-site morbidity and extension deficit. DOI: 10.3329/jbcps.v27i1.4240 J Bangladesh Coll Phys Surg 2009; 27: 25-29

scholarly journals GLABROUS & NON-GLABROUS SPLIT SKIN GRAFT IN THE RECONSTRUCTION OF FLEXION CONTRACTURE OF FINGERS – AN OBSERVATIONALAND COMPARATIVE STUDY.

2020 ◽  
pp. 1-3
Author(s):  
Abhishek Gaur ◽  
Nidhi Gaur
Keyword(s):  
Skin Graft ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Flexion Contracture ◽  
Split Thickness Skin Graft ◽  
Skin Grafts ◽  
Flexion Deformity ◽  
Split Skin Graft ◽  
Thickness Skin ◽  
Split Skin

Background: Flexion contractures of the fingers cause functional and aesthetic problems to a burn patient. Various methods of reconstruction have been described in the literature. These include release and split thickness grafting, release and full thickness grafting. Among those incision or excision of the contracture band and split skin grafting were the simplest and commonest techniques. In this study, we aim to compare functional & aesthetic outcomes of glabrous & non glabrous split skin graft in flexion contracture of fingers. Methods: A total of 60 fingers of patients of post burn finger contractures were undertaken for the study. Patients were evaluated preoperatively on duration of contracture, extent of involvement, type of scar, range of movements using goniometer and degree of fixed flexion deformity. Finger contractures were released and resurfacing done with glabrous & non-glabrous split thickness skin grafts. Postoperative evaluation was done by measuring range of movements of Proximal Interphalangeal (PIP) and Distal interphalangeal (DIP) joints, flexion deformity, donor site morbidity, number of visits to the hospital, colour match of graft to adjacent skin. Results: Functional outcome in terms of active range of motion combined at DIP joint, PIP joint & metacarpophalangeal joint were similar in both glabrous split thickness skin graft & non glabrous split thickness skin graft at the end of six months. As compared with non-glabrous split thickness skin grafts, glabrous split thickness grafts provided superior colour & texture match to surround tissue. There was no significant donor site morbidity in plantar in-step area & patients were able to walk from third to fourth post operative day. There was minimal hypertrophy of plantar donor site, owing to persistent pressure in standing posture. Conclusion: Patient’s satisfaction was greater in glabrous split skin graft.

scholarly journals A study of crystalluria: effectiveness of including hygienic-dietary recommendations in laboratory reports

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Paula Sienes Bailo ◽  
María Santamaría González ◽  
Silvia Izquierdo Álvarez ◽  
Raquel Lahoz Alonso ◽  
Patricia Serrano Frago ◽  
...  
Keyword(s):  
General Population ◽  
Observational Study ◽  
Renal Colic ◽  
Incidence Rates ◽  
Retrospective Observational Study ◽  
Dietary Recommendations ◽  
Group A ◽  
Group B

Abstract Objectives To assess the effectiveness of incorporating hygienic-dietary recommendations in laboratory reports in reducing the incidence of renal colic (RC). A study was performed to compare the incidence of RC in two groups of patients who had suffered at least a crystalluria event associated with the risk of urolithiasis. Recommendations were only incorporated in the laboratory reports of one group. Methods A retrospective observational study. The study sample was composed of patients who had at least an episode of crystalluria associated with a higher risk of urolithiasis. The laboratory reports of patients in Group A (n=1,115), treated in 2017, did not include any hygienic-dietary recommendations, whereas patients in Group B (n=1,692), treated in 2018, received hygienic-dietary recommendations through their laboratory reports. χ2 and Mann-Whitney U test were used to assess differences based on sex, age, and type of urinary crystals. Results The incidence of RC was 2.02 times higher in group A (2.24%) than in group B (1.12%). No significant differences were observed in the incidence of RC based on the type of urinary crystal. The incidence of RC was substantially higher in patients who suffered at least an event of crystalluria associated with a higher risk for urolithiasis as compared to the general population during the same period (0.46%, consistently with the incidence rates reported in the literature). Conclusions The incorporation of messages alerting on the risk of urolithiasis and the inclusion of hygienic-dietary recommendations in laboratory reports may be useful for reducing the incidence of RC.

Uncommon Responses of Segmental Vitiligo to Melanocyte-Keratinocyte Transplantation Procedure

2015 ◽  
Vol 19 (2) ◽  
pp. 177-181 ◽  
Author(s):  
Prescilia Isedeh ◽  
Ahmed Al Issa ◽  
Henry W. Lim ◽  
Smita S. Mulekar ◽  
Sanjeev V. Mulekar
Keyword(s):  
Observational Study ◽  
Skin Grafting ◽  
Retrospective Observational Study ◽  
Recipient Site ◽  
Treated Area ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Background Patients with segmental vitiligo (SV), unlike those with nonsegmental vitiligo (NSV), have a more predictable course and are more responsive to surgery. Objective To report 10 patients with SV treated with the melanocyte-keratinocyte transplantation procedure (MKTP), who responded with unusual responses not previously reported in the literature. Methods This is a retrospective, observational study that reports 10 patients with SV who underwent the MKTP between May 2003 and May 2012. Results Two patients had successful repigmentation after split-thickness skin grafting after failure of the MKTP. Two patients developed a hypopigmented ring at a margin of the MKTP-treated area. One patient had complete repigmentation after a second MKTP. Two patients developed koebnerization of the recipient site. Three patients developed new vitiligo patches in previously unaffected areas after the MKTP. Conclusions Uncommon and even suboptimal responses can occur following the MKTP in SV patients. There is a need for studies to provide better understanding and outcomes for SV patients undergoing the MKTP.

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