Abstract

Awe Oluwafemi Olasupo*, Ukpebor Famous and Aigbonoga Quincy Oshiomede

ABSTRACT

Introduction: Split thickness skin grafting is one of the reconstructive options available to surgeons after a soft tissue loss. It is a common procedure performed by most Surgeons. Donor site morbidities has been the major drawback in the acceptance of this procedure to the patients. Any technique that will significantly reduce the donor site morbidity will be well appreciated. Aim: To know if there is a significant reduction in the rate of morbidity in petrolatum gauze dressing of split thickness skin grafting with serial de-bulking and topical antimicrobial application Methodology: this is a prospective study comparing the rate of morbidities in patients with serial de-bulking of petrolatum gauze dressing and the control group. Group A had serial de-bulking on day 5, 10, and group B had none until review on day 14. The patients are serially allocated into each group with all the odd number patients in Group A while all the even number patients in Group B. These are the patients that have indication for skin grafting and accepted to be part of the study. Patients with medical co-morbidities were excluded from the study. The P-value < 0.05 is considered statistically significant. Results: 50 patients were involved in the study with 25 patients in each group. All the patient had donor sites on the unilateral thigh, though the extent of the donor was not considered in the study. The male to female ratio of 1.35:1 in group A and 1.5:1 in group B, with P-value of 0.54. The age mean age 45.6years in group A while the mean age 43.5years in group B, the P-value of 0.35. Trauma is the commonest aetiology in the study in both groups, followed by necrotizing fasciitis. Wound delay and wound infection were 20% and 12 % in group A and 40% and 28% in group B respectively. The P-value of 0.034 and 0.015 for delay wound healing and wound infection respectively. Conclusion: serial de-bulking and application of topical antimicrobial agent reduces the donor sites morbidity significantly.