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Bedside Split Thickness Skin Graft using a Safety Razor Blade: A Forgotten Surgical Art
Abstract
Background: Orthopedic and Plastic surgeons deal with wounds on daily basis. Open fractures are prone to development of deep infections which may result in infected non-unions or chronic Osteomyelitis, the management of which are complicated. Split thickness skin graft done in the theatre is the standard means of dealing with wounds in our environment. Because of patient poverty or for the expediency of dealing with wounds as fast as possible, bedside split thickness skin graft using hand-held razor blade may be employed to cover wounds. We present our experience with fifteen patients on this method of wound care in resource depleted environment.
Methods: Clean granulating wounds of 2- 7cm2 or less were selected for bedside split thickness skin grafting. This size was chosen because they are easier to manage. Wounds bigger than this size do not heal by secondary intention in a short time and when they heal, do so with an unstable scar or some contracture. Skin donor site is cleaned and grafts harvested aseptically using hand-held safety razor blade. Grafts are transferred to the recipient site immediately.
Results: Fifteen patients were managed over a period of five years. Their skin defects ranged from 2-7cm2. They are mostly caused by trauma while some resulted from tumor excision, burns and infections in diabetics Graft take ranged from 50-100% with success being affected negatively by infection with pseudomas aeroginosa.
Conclusion: Reasonable outcomes can be expected in bedside split thickness skin graft applied on the bedside. Normal complications of skin grafting may occur but can usually be overcome to give good results.
Methods: Clean granulating wounds of 2- 7cm2 or less were selected for bedside split thickness skin grafting. This size was chosen because they are easier to manage. Wounds bigger than this size do not heal by secondary intention in a short time and when they heal, do so with an unstable scar or some contracture. Skin donor site is cleaned and grafts harvested aseptically using hand-held safety razor blade. Grafts are transferred to the recipient site immediately.
Results: Fifteen patients were managed over a period of five years. Their skin defects ranged from 2-7cm2. They are mostly caused by trauma while some resulted from tumor excision, burns and infections in diabetics Graft take ranged from 50-100% with success being affected negatively by infection with pseudomas aeroginosa.
Conclusion: Reasonable outcomes can be expected in bedside split thickness skin graft applied on the bedside. Normal complications of skin grafting may occur but can usually be overcome to give good results.
