Background: Split skin grafts are frequently employed to provide biological cover for extensive wounds. The clinical outcome of skin grafts depends on a variety of factors of which infection is one of the most important. The intent of this study was to define the micro-organisms causing skin graft infections and failures at the National Reconstructive Plastic Surgery and Burns Centre (NRPSBC) at the Korle Bu Teaching Hospital (KBTH). Aim: The study assessed the extent to which bacterial infection of grafted wounds resulted in graft failure and subsequent re- grafting.Materials and Methods: The study was a longitudinal study conducted on the wards of the NRPSBC at the KBTH on patients with wounds who received split skin grafts. Wound swabs of discharging grafted wounds were inoculated into a Stuarts’ transport medium to prevent desiccation and transported immediately to the microbiology laboratory for further processing.Results: Fifteen (20.8%) of the grafts failed to take. The incidence of infected grafted wounds was 79.2% (57). Infected grafted wounds that resulted in graft failure were 14 out of 57 infected wounds (24.6%). Pseudomonas aeruginosa and Other Pseudomonas Species were identified as the bacteria frequently involved in graft failure at the NRPSBC.Conclusion: In this study, we found a graft failure rate of 20.8%. This was influenced by the bacterial load present in the graft bed.Â
Introduction: The vacuum-assisted closure (VAC) has proved to be very promising in the management of difficult to heal wounds. However, the first reports about the use of negative pressure wound device came from Argenta and Morykwas in the year 1997. Though there are various commercially prepared and manufactured vacuum assisted closure dressing materials, these are often unavailable or unaffordable to patients in third world countries. Our “homemade” vacuum dressing has been found to be, affordable for our patients and most importantly effective in wound management. Materials and methods : The homemade Vacuum Assisted closure dressing was used for the management of some wounds which presented at our centre. These wounds were irrigated and thoroughly debrided. Our homemade vacuum assisted closure dressings were subsequently applied. Results: The wounds healed well with good granulation tissue. Subsequent split thickness skin graft (SSG) done had very good take. The VAC dressing often resulted in good wound contraction with no need for SSG. Conclusion: In our practice our “home made” vacuum which was affordable and customized proved to be effective in wound management.
Introduction: Several Local flaps can be used for the reconstruction of digital soft tissue defects with exposure of tendons and/or phalanges. The homodigital flap is a versatile option. This article discusses the use of the homodigital reverse vascular island flap-a regional, axial-patterned skin flap in the reconstruction of distal digital defects.Methods: 6patients with a soft-tissue defect at the distal part of the finger were treated by homodigital island flaps for reconstruction. We evaluated the active range of motion of the involved finger, and the patient's satisfaction with the appearance of the finger after reconstruction.Results: All patients admitted to a good functional outcome. The donor site morbidity was minimal. The take of the split-thickness skin graft to the flap donor site was generally good. However one patient complained of numbness of the finger over the donor site. Conclusion:The Homodigital flap is a handy multipurpose flap that can be used. Notwithstanding its limitation, it is easy to raise and it can be used to a variety of defects.
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