Split skin graft for diabetic ulcers: an analysis

Abstract

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.

A Meta-Analysis of the Outcomes of Split-Thickness Skin Graft on Diabetic Leg and Foot Ulcers

“…Basic characteristics of the 11 studies are shown in Table 1. [12][13][14][16][17][18][19][20][21][22][23]…”

“…The weighted pooled recurrence rate was 4.2% (95% CI = 0.009-0.096, I 2 = 76%). 13 Hu et al 14 Jeon et al 16…”

“…[8][9][10][11] Few authors reported outcomes of split-thickness skin graft (STSG) placement as a primary means of healing leg ulcers or diabetic dorsal wounds of the foot. [12][13][14] Although elective surgery in patients with poorly controlled diabetes was reported to increase postoperative complications, no evidence stated the same in relation to STSG. 15 Many reports claimed that there is actually a low complication rate when treating patients having DFUs with STSG.…”