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Title: Outcome of split-thickness skin graft (STSG) in complex orthopaedic trauma.
Authors: Ajay Kumar, Zain Naseer, Zameer Abbas, Haseeb Elahi, Haseeb Hussain, Muhammad Ikram
Journal: The Professional Medical Journal (TPMJ)
Publisher: Independent Medical College, Faisalabad- Pakistan
Country: Pakistan
Year: 2023
Volume: 30
Issue: 10
Language: English
DOI: 10.29309/TPMJ/2023.30.10.7504
Keywords: Split-thickness skin graft (STSG)Complex OrthopedicsSkin PigmentationVac Dressing
Objective: Complex orthopedics wounds are challenges to surgeon and patient in operative management. Road traffic accidents, the major cause of open fracture, represent a massive global health problem with high mortality and morbidity rates. Study Design: Retrospective study. Setting: Ghurki Trust Teaching Hospital, Lahore. Period: January 2021 to January 2022. Material & Methods: Thirty eight patients with open fractures with skin loss, treated with graft, and wound where a flap was not possible were included in the study. The outcome was assessed in terms of the outcome of STSG in complex orthopaedic trauma. Results: A total of 38 patients were included who underwent STSG graft. Among these, more than half of cases, 33(86.8%), were males, while 5(13.2%) were female cases with a mean age of 25.82±13.09 ranging from (6-63) years. Graft loss was found in 4 cases (10.5%), graft contracture in 7 cases, altered sensation in three cases, skin pigmentation in 4 cases, episode infection in 8 cases, and skin breakdown in only one case observed. Average hospital stay ranged from 2-3 weeks in all cases. Conclusion: It is concluded that Acute complex orthopedics wounds present a unique challenge for surgeons. Good surgical technique, early appropriate surgical intervention, source control, early use of broad-spectrum antibiotic therapy, VAC dressing, and early tissue coverage prevent wound infection and decrease the chances of limb amputation.
To determine the outcome of split-thickness skin graft (STSG) in complex orthopaedic trauma.
Retrospective study conducted at Ghurki Trust Teaching Hospital, Lahore, from January 2021 to January 2022. Thirty-eight patients with open fractures and skin loss, where a flap was not possible, were included. Data was collected using a predefined questionnaire and analyzed using SPSS software.
graph TD;
A["Ethical Approval & Patient Selection"] --> B["Data Collection via Questionnaire"];
B --> C["Data Analysis using SPSS"];
C --> D["Outcome Assessment of STSG"];
D --> E["Report Findings"];
The study highlights that young males are predominantly affected by complex orthopaedic trauma, often due to high-speed vehicle accidents. STSG showed promising outcomes in terms of graft loss, contracture, and altered sensation compared to some existing literature, though infection rates were notable. Early surgical intervention, appropriate antibiotic therapy, and VAC dressing are crucial for preventing complications.
A total of 38 patients (86.8% male, 13.2% female) with a mean age of 25.82±13.09 years underwent STSG. Graft loss occurred in 10.5% of cases, graft contracture in 18.4%, altered sensation in 8%, skin pigmentation in 10.5%, and infection in 21.1%. Skin breakdown occurred in 2.6% of cases. Average hospital stay ranged from 2-3 weeks.
Acute complex orthopaedic wounds present significant challenges. STSG is a viable option for wound coverage when flaps are not feasible, demonstrating noteworthy outcomes. Good surgical technique, prompt intervention, infection control, and early tissue coverage are essential to prevent complications like infection and amputation.
1. Study Period: The study was conducted from January 2021 to January 2022. (Confirmed in Material & Methods)
2. Number of Patients: 38 patients were included in the study. (Confirmed in Abstract and Results)
3. Male Percentage: 86.8% of the patients were male. (Confirmed in Results)
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