Impact of Diabetes and Comorbidities on Split-Thickness Skin Grafts for Foot Wounds

Ramanujam, Crystal L.; Han, David K.; Fowler, Sharon P.; Kilpadi, Krista L.; Zgonis, Thomas

doi:10.7547/1030223

Cited by 29 publications

(31 citation statements)

References 28 publications

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“…5 Ramanujam et al in their study showed that the healing time though was same in diabetics and non-diabetics without co morbidities, it was prolonged in diabetic patients with comorbidities. 6 In other studies, the average wound healing time ranged from 5.1 to 6.5 weeks which was comparable with our study. 3,4 In the study by Anderson et al, the complication rate was 2.8% which is slightly smaller than our complication rate.…”

Section: Discussionsupporting

confidence: 92%

Split skin graft for diabetic ulcers: an analysis

2016

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Background: Most diabetic wounds are slow healing and have a considerable area for which healing takes a long duration by conservative methods. Hence we wanted to check the effectiveness of methods of accelerating the healing process. Aim of the study was to analyse the effectiveness of split skin grafting as a curative procedure in these ulcers. Methods: A retrospective analysis of 100 cases of diabetic ulcer who had undergone split skin grafting between 2009 and 2012 was performed to check the effectiveness of the procedure in curing the ulcer. Results: Split skin graft cured about 88% of the patients (graft take more than 90%) with recurrence of about 5%. The rest had graft taken less than 90% but the ulcer had healed. Donor site infection was seen in 5% and all were treated conservatively. Conclusions: The major goal in diabetic foot management programmes is to reduce morbidity, early wound healing and early ambulation. This procedure of split skin grafting helps to achieve this. But the ideal way forward is to avoid the development of such diabetic ulcers by patient education and improving glycemic control. Follow up in diabetic clinics should include vascular and neuropathic assessment of the foot and education about foot care.

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Section: Discussionsupporting

confidence: 92%

Split skin graft for diabetic ulcers: an analysis

2016

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“…Ramanujam et al, [16] retrospectively reviewed 203 patients who underwent STSG to ascertain the differences in healing time, necessity to perform revisional surgery and postoperative infections. With the help of this data, they developed a predictive model that can identify diabetic patients who are likely to have a successful STSG.…”

Section: Resultsmentioning

confidence: 99%

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

Maramreddy¹

2016

IJARS

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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.

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“…Many components are useful for an effective STSG dressing: compression to prevent hematoma/seroma, control of shear forces to prevent graft movement, maintenance of moisture to promote graft viability, and general protection from the external environment ( 8 ). Several studies in diabetic foot wounds have demonstrated the successful use of a bolster dressing consisting of non-adherent petrolatum gauze with sterile plain sponges moistened in saline to firmly secure the graft in place ( 5 , 9 – 11 ) or by NPWT securing the STSG continuously for approximately 5 days. In cases of isolated STSG for diabetic foot wounds, the affected lower extremity can also be immobilized in a posterior splint to prevent motion during the healing phase.…”

Section: Operative Techniquementioning

confidence: 99%

Stepwise surgical approach to diabetic partial foot amputations with autogenous split thickness skin grafting

Ramanujam

Zgonis

2016

Diabetic Foot & Ankle

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In the surgical treatment of severe diabetic foot infections, substantial soft tissue loss often accompanies partial foot amputations. These sizeable soft tissue defects require extensive care with the goal of expedited closure to inhibit further infection and to provide resilient surfaces capable of withstanding long-term ambulation. Definitive wound closure management in the diabetic population is dependent on multiple factors and can have a major impact on the risk of future diabetic foot complications. In this article, the authors provide an overview of autogenous skin grafting, including anatomical considerations, clinical conditions, surgical approach, and adjunctive treatments, for diabetic partial foot amputations.

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Impact of Diabetes and Comorbidities on Split-Thickness Skin Grafts for Foot Wounds

Abstract: For individuals with diabetes but without exclusionary comorbidities, split-thickness skin grafting may be considered an effective surgical alternative to other prolonged treatment options currently used in this patient population.

Cited by 29 publications

References 28 publications

Split skin graft for diabetic ulcers: an analysis

Split skin graft for diabetic ulcers: an analysis

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

Stepwise surgical approach to diabetic partial foot amputations with autogenous split thickness skin grafting

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