Comparative Study of Dermatotraction and Split Skin Grafting in Infected Ulcers at Tertiary Care Hospital in...

Ulcers with skin loss causes lot of complications leading to delay in wound healing, prolonged hospital stay and complications like wound infections, need for prolong hospital stay, need for multiple surgery. Split skin grafting technique comprises of harvesting the skin graft from the healthy skin areas and is used to cover the exposed ulcers. With time newer techniques to treat ulcers were developed out of which one of the method is called as Dermatotraction. This technique utilizes the skin characteristics of stress relaxation (creep) and delayed primary closure is used. The procedure involves the approximation of the skin edges using the method of shoelace technique and a gradual skin traction is applied for a period, and when the two ends approximate secondary suturing is done.

To assess the outcomes of Dematotraction vs Split skin grafting in infected ulcers in a Tertiary Care Hospital in Mangalore.

a) To Determine the clinical outcomes of the dermatotraction on complex wounds of varying size and shape, b) To analyze the outcomes of dermatotraction by comparing to Split Skin Grafting.

This study was done in Department of General Surgery. Prior to the study approval from the ethical committee was obtained and the study was done on the patients as per listed in the inclusion criteria. A total 52 cases were performed 26 cases in dematotraction group 26 cases in Split Skin Grafting group.

The dermatotraction group was done in the 26 patients of which 18 patients was treated with the technique of primary closure and 6 patients had to undergo dermatotraction followed by secondary suturing, 2 patients had infection required further treatment. The split skin grafting 22 cases had uptake and 4 cases had graft rejection of which16 cases had complete uptake with 6 cases had partial uptake and 4 cases had complete rejection of the graft. Of the 26 cases in split skin grafting 4 patients also had donor site infection. Dermatotraction group had good cosmetic appearance with intact tactile sensations compared to the split skin grafting.

Split skin grafting has been a conventional method of treatment for peripheral limb ulcers. In this study we have found dermatotraction can be a cost effective, feasible procedure in selected patients with better outcomes and the quality of life. Further studies are warranted to establish dermatotraction to be considered as a standard of treatment for peripheral limb ulcers.