DONOR SITE MORBIDITY FOLLOWING HARVEST OF SPLIT-THICKNESS SKIN GRAFTS IN SOUTH EASTERN NIGERIA

Split-thickness skin grafting is a very common procedure. Few documentation of its complications exist in the literatures especially in our sub-region where excessive scarring is a major issue.

The objective of the study was to document the common complications observed at the donor site for split thickness skin grafts.

This is a prospective study carried out at the National Orthopaedic Hospital, Enugu, Nigeria over a six month period. All patients with wounds requiring split-thickness skin grafts, who gave consent, were recruited. An observer administered questionnaire was opened for each patient. Any donor site complication was noted on inspection and documented. Analysis of the results was done using SPSS with frequencies, mean and test of significance.

A total of 120 patients were recruited for the study. Males accounted for 59.2% of the patients while females made up 40.8%. Donor site complications noted were pain which was exaggerated after 24 hours, itching, infection, dyschromia, hypo-pigmentation, hyper-pigmentation, and hypertrophic scars. At 1 month post-operative period, dyschromia was the commonest complication (39.2%), followed by itching (22.5%), hypo-pigmentation (19.2%), infection (17.5%), and exaggerated pain (1.7%). However, by 3 months, hyper-pigmentation was most common (55.4%), followed by dyschromia (37.5%), hypertrophic scar (3.6%) and itching (3.6%). Whereas by 6 months most patients had hyper-pigmentation (96.0%) while 4.0% had hypertrophic scars. The exaggerated pain was treated successfully with analgesics and was no longer present in any patient after the first month. While infection was also treated successfully following wound swab culture and sensitivity, appropriate antibiotic therapy and local wound care. Pigmentation changes were in keeping with previous studies as hyper-pigmentation was an invariable event following healing of a partial thickness wound.

Donor site morbidity can be a big problem especially with regard to infection which increases duration of admission and therefore cost of management.