Comparison of Conventional Technique versus Serial Tangential Excision of Raw Area and Split Skin Grafting.

Author(s): Dr. Zia Uddin

BACKGROUND In patients with chronic wound (raw area) skin grafting is a simple and common procedure for achieving wound closure. The split skin graft can be applied on wound after scraping or after serial tangential excision of granulation tissue. This is a prospective comparative study between the two methods. METHODS This is a longitudinal study of follow up and comparative study and was carried out in the department of General Surgery of GSVM Medical College, Kanpur, and LLR Hospital, Kanpur, from January 2017 to October 2018. 172 patients were included in the study and divided in to two groups- group A (105 patients) and group B (67 patients). In group A, skin grafting was done after serial tangential excision of granulation tissue. In group B, skin grafting was done after scraping of granulation tissue with scoop. Percentage of graft uptake, duration of hospital stay, number of post op dressing, comorbid conditions and duration of disease were assessed. RESULTS In group A in 91 (86.6%) patients had skin take between 95-100% and 4 (3.8%) patients had a take-rate between 90-95%. 10 (9.5%) patients had take-rate in 80-90% range. No patient had a take of <80%. In group B 12(17.9%) patient had take-rate between 95 and 100%. 13 (19.4%) patients had take-rate of 90-95%. 39 (58.2%) patients had take-rate between 80 and 89%. 3 (4.4%) patients had take-rate of less than 80%. This was statistically significant. CONCLUSIONS After serial tangential excision of granulation tissue, the split skin graft uptake is increased as compared with only scraping of the wound. The factor associated with this was removal of infection, less hematoma and less seroma formation.