Survival of Split Thickness Skin Graft in Diabetic and Non-diabetic Wound Management

Abstract

Introduction: Split skin grafting is widely used surgical procedure for the treatment of ulcers. Graft survival depends on number of factors like vascularity, wound infection etc. diabetes is associated with endothelial dysfunction, neuropathy, wound infection which collectively affect the graft survival. Aim: To compare the amount of graft uptake, the post operative complications and survival of split thickness skin graft in diabetic and non diabetic wound management. Materials and Methods: In our prospective nonrandomized comparative study total 104 patients with ulcer were included of which 52 were diabetic and 52 were non-diabetic. All of them underwent split skin grafting as part of their wound management. Comparison was made between two groups in terms of amount of graft uptake, post operative wound infection, re-ulceration, revisional surgery, donor site infection. Results: Average wound surface area in diabetic group is 42.31 cm2 and average graft uptake is 23.67 cm2 , in non-diabetic group average wound surface area is 78.06 cm2 and average graft uptake is 64.06 cm2 . Compared with non-diabetics, diabetics have significantly less graft uptake (p0.3, not significant). 13(25%) out of 52 in diabetic group developed post operative graft infection, 7(13.5%) out of 52 in non-diabetic group developed graft infection (p > 0.1, not significant). None of the patients in the study developed donor site infection. Conclusion: Diabetes is associated with poor graft survival and high post operative complication rates in patients undergoing split skin grafting.

Keywords

• graft infection
• microangiopathy
• revisional surgery