Cadaveric donor skin allograft as a temporary dressing material in the management of complicated wounds
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Date
2019
Authors
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Journal ISSN
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Publisher
Educational Society for Excellence
Abstract
Introduction: Wounds resulting from various causes are the most common health problem in developing countries like India. Management of these wound is very difficult, requiring longer hospital stay, loss of income, psychological problems like depression. In our study, we used cadaveric donor skin as a temporary dressing material for wound cover and see the outcome of definitive splitthickness skin graft following cadaveric donor skin application. Previously cadaveric skin was used for covering the burns wound. Only very few studies are available regarding the use of cadaveric donor skin in the management of complicated wounds. Materials and methods: This was a prospective, non-randomized, uncontrolled study conducted in the Department of General Surgery, Government Stanley Medical College Hospital from October 2017 to September 2018. Once the wound scheduled for cadaveric grafting, the cadaveric skin was meshed in the laminar flow cabinet, the skin was washed in the normal saline, to ensure that all the preservative fluid had been removed. The skin is transported in a sterile container. The cadaveric graft was applied to the wound. No fixation done. Limb was immobilized using POP. Sterile was dressing done. Results: In our study 44 patients underwent cadaveric donor skin grafting. In 40 out of 44 patients (90.9%), the cadaveric donor skin had good take. All 40 patients underwent definitive split-thickness skin grafting. The mean graft take was 90.35%, with maximum graft take was 96% and minimum graft take was 82%. The standard deviation was 3.512%. When reviewing the literature which showed the success rate of STSG was 78% at closing 90% of the wound by 8 weeks. In our study, the mean duration of hospital stay was 34.2 days, with maximum of 57 days and a minimum of 17 days. Most Jim Jebakumar, S. Ranjith Kumar. Cadaveric donor skin allograft as a temporary dressing material in the management of complicated wounds. IAIM, 2019; 6(3): 65-72. Page 66 of the wounds required only single cadaveric graft application, 37 (84.1%) out of 44 patients and 7 patients (15.9%) required more than one cadaveric donor skin grafting. Conclusion: By this study, we can able to minimize the expenses by using the cadaveric skin to predict the success of definitive split-thickness skin grafting. We can also minimize the duration of hospital stay and prolonged use of antibiotics if the cadaveric skin take is successful.
Description
Keywords
Complicated wounds, Cadaveric donor, Skin allograft, Biological dressing material
Citation
Jebakumar Jim, Kumar S. Ranjith. Cadaveric donor skin allograft as a temporary dressing material in the management of complicated wounds. International Archives of Integrated Medicine. 2019 Mar; 6(3): 73-82