Success of skin grafting on a contaminated recipient surface

✍ Scribed by A. Zekri; W. King

• Publisher: Springer
• Year: 1995
• Tongue: English
• Weight: 217 KB
• Volume: 18
• Category: Article
• ISSN: 1435-0130
• DOI: 10.1007/bf00183697

✦ Synopsis

Over a three-year period, 90 burn patients having split thickness skin grafting were studied. The deep burn surface area ranged from 5 to 35% of TBSA. All had a positive bacterial contamination of the burned area greater than >100,000 organism per gram. The conventional method of burn management was used. All cases had preoperative baths and povidone iodine soaks. Postoperative topical antibiotics were applied to the grafted site, selected by culture and sensitivity testing. There was an 80-95% take of the graft in 87 cases, 50% in two cases, and in one case there was complete graft loss. The latter ,was due to the presence of another species of contamination not specified by the culture and sensitivity at the time of surgery. Another five patients with a similarly infected recipient surface were grafted without applying the above protocol; this was considered as a "control group". Two out of five cases showed a graft take of less than <20% and there was complete graft loss in the other three cases. This postulated that diligent cleansing with antiseptic soaks is effective in reducing the bacterial count, Specific topical antibiotics inhibit the bacterial action on the granulation tissue surface, as they do in vitro until early vascularization required for graft adhesion occurs. Using this simple protocol, good graft take could be achieved even in the presence of bacterial contamination; thus resulted in a shorter hospital stay.