A Clinicopathological Study on Split Thickness Skin Graft Uptake in Diabetics and Factors Affecting Graft Uptake

Dias RH, Salelkar R, Rodrigues J, Rodrigues FCS and Parsekar S

Department of General Surgery, Goa Medical College, India

^*Correspondance to: Frazer CS Rodrigues 

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Abstract:

Introduction: Split thickness skin grafting is a preferred treatment for ulcers. Studies have shown the graft uptake and outcome to be poor in patients with diabetes and other comorbidities as compared to non-diabetics and diabetics without comorbidities. Aim: This study aimed to assess the outcomes of STSG in diabetic patients in terms of the prevalence of comorbidities among diabetics undergoing Split Thickness Skin Graft and factors affecting graft uptake with incidence of graft failure on patient follow up to predict the outcome of STSG and aid in proper patient selection. Methodology: This prospective descriptive study was conducted in 40 patients with >18 years of age with ulcers having healthy granulation tissue and no contraindication for split thickness skin grafting. All the patients underwent STSG for the management of ulcer after following standard criteria. Donor site in all patients was the thigh. Patients were followed up after 1 month and graft status noted and any residual ulcer size was measured. Eighty percent take of the skin graft was considered to be successful graft uptake. Results: The mean graft uptake percentage in this study was 81.14 ± 30.434. In the average percentage uptake was 95.47 ± 5.615 and 31.76 ± 29.3 respectively in successful graft uptake group and graft failure group, average graft uptake percentage was. Among the graft success group 20 (64.5%) out of 31 patients had a positive swab culture while among the graft failure group 8 out of 9 patients had a positive swab culture with the most common organism being Pseudomonas species (50% and 55.6% respectively). There was statistically significant association of hypoalbuminemia with poor graft uptake. Conclusion: The rate of graft failure in diabetics undergoing split thickness skin graft was 18.86% with hypoalbuminemia as a significant factor affecting graft uptake and Pseudomonas species being most common infection affecting graft uptake.

Keywords:

Split thickness skin graft; Diabetes mellitus; Ulcers; Graft uptake

Cite the Article:

Dias RH, Salelkar R, Rodrigues J, Rodrigues FCS, Parsekar S. A Clinicopathological Study on Split Thickness Skin Graft Uptake in Diabetics and Factors Affecting Graft Uptake. World J Surg Surgical Res. 2023; 6: 1458..