Инновационная медицина Кубани (Nov 2024)

Peculiarities of Improving Surgical Treatment of Wounds With Full-Thickness Skin Autografts

  • S. B. Bogdanov,
  • V. A. Aladina,
  • M. L. Mukhanov,
  • S. L. Zaitseva,
  • V. S. Dutov,
  • D. S. Zakeryaeva

DOI
https://doi.org/10.35401/2541-9897-2024-9-4-30-37
Journal volume & issue
Vol. 0, no. 4
pp. 30 – 37

Abstract

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Background: Despite advances made in combustiology, the method and timing of wound closure remain a matter of debate. There are 2 decisive factors in engraftment of a full-thickness skin graft: infection degree and level of wound bed vascularization. Reasons for unsuccessful engraftment are insufficient hemostasis, late surgery, and exposed subcutaneous fat. Full-thickness skin grafting for wounds of various origins optimizes improvement of long-term cosmetic and functional results of surgery.Objective: To improve treatment results in patients with wounds of various etiologies by improving methods of full-thickness skin autografting.Materials and methods: This study was conducted in the Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1 (Krasnodar, Russian Federation) and analyzed data from 64 patients (age, 18-65 years) who underwent full-thickness skin autografting. The patients were grouped based on the surgery type.In group 1 (23 patients with acute burn injury), granulation tissue was excised, and the wound defect was closed using a full-thickness skin autograft. In group 2 (21 patients with scar deformities of the skin), scar tissue was excised, and full-thickness skin autografting was performed. Group 3 (20 patients with traumatic skin detachment without bone injury) underwent skin grafting by the Krasovitov method.Results: Time to engraftment in group 1 was median 10.0 (7.5; 15.0) days; in group 2, 15.0 (13.0; 18.0) days, and in group 3, 28 (14.8; 44.3) days. We found statistically significant differences when comparing the groups using the Kruskal-Wallis test (P < .0001).Conclusions: New developed methods for full-thickness skin autografting in patients with granulation tissue and scar deformities can significantly increase the treatment effectiveness.

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