Posted in Volume 16 - Number 1
GHULAM HYDER RIND, SAYED QARIB ABBAS SHAH, KHUSH MOHAMMAD SOHU, AZHAR ALI SHAH
ABSTRACT | Full Text PDF
OBJECTIVE: The goal of this study was to evaluate the results of skin grafting in a general surgical ward.
STUDY DESIGN: A prospective observational study.
PLACE AND DURATION OF STUDY: This study was carried out in Surgical Unit of Ghulam Mohammad Maher Medical College Hospital Sukkur, from August 2006 to July 2009.
PATIENTS AND METHODS: All patients admitted to our unit who required split thickness skin graft were included in the study. A total of 75 patients, 57 males and 18 females were studied. Complete history, local, systemic and thorough general physical examination with relevant investigations carried out and recorded in a comprehensive Performa. Contaminated wounds were cultured and treated with dressings and wound cleaning under cover of appropriate antibiotic according to sensitivity reports. Grafts were taken from the thigh and arms wherever applicable, with Hamby’s knife and even with shaving blade under general, spinal and local anesthesia depending upon requirement of each case. Most of the grafts were applied in small stamp shapes but some required sheets stitched with healthy skin to avoid slipping. Antibiotic cover practiced in therapeutic doses. The grafts at joints required POP splints and slabs. Dressings were routinely examined on 5th postoperative day.
RESULTS: A total of 75 patients, 57 males and 18 females were studied. Most of the patients were between the ages 25 to 50 years of age. Degloving injuries and burns were the commonest cause of extensive wounds (64%), followed by various causes like fungating skin lesions and breast tumors. In 10 patients there was graft rejection due to infection. Patients with wounds in lower leg and especially around ankle (5%) were the most resistant. There was no mortality and the commonest complication was wound infection in 21 patients, Staphylococcus Aureus being the main organism. The mean hospital stay was 22.5 days.
CONCLUSION: To relieve the work load of plastic surgeon, the skin grafting can be performed by general surgeons. The spilt-thickness skin grafting is very useful method to cover the large wounds unable to close otherwise. The infection can controlled with vigilant approach and other modern methods should also be tried.
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