Early Outcomes and Complications of Skin Graft Reconstruction for Complex Wounds at a Tertiary Hospital: A...

Background: Complex wounds present significant reconstructive challenges owing to impaired healing, infections, and tissue loss. Skin grafting remains a widely used reconstructive technique; however, outcome data from the Gulf region are limited to a few studies. This study aimed to evaluate early graft outcomes and complications following skin graft reconstruction for complex wounds at a tertiary hospital. Methods: A retrospective, hospital-based study was conducted at Sultan Qaboos University Hospital (SQUH), including all patients who underwent split-thickness or full-thickness skin grafting between 2023 and 2025. Demographic, clinical, surgical, and wound-related data were collected. The main outcomes were graft take on postoperative days 5-7, time to complete re-epithelialization, and the occurrence of postoperative complications. Results: A total of 50 patients were included; 72% were males, with a median age of 45.5 years. Diabetes mellitus was present in 34% of patients. Trauma (28%) and infection/necrotizing causes (22%) were the most common etiologies of wounds. Complete graft take (>90%) was achieved in 90% of the patients, whereas 10% had partial graft take. The median time to complete re-epithelialization was 13 days. Complications were infrequent and minor, including postoperative infection (8%), hypertrophic scar formation (6%), and wound dehiscence (2%). No significant differences in healing time were observed between the diabetic and non-diabetic patients. Conclusions: In this descriptive institutional cohort, a combined protocol of wound-bed preparation, skin graft reconstruction, and postoperative NPWT-assisted stabilization was associated with favorable early graft take and fewer complications. These findings should be interpreted cautiously because of wound heterogeneity, unavailable wound size measurements, and limited subgroup sizes. Larger prospective studies are needed to evaluate the predictors of graft success.