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Stored skin--stored trouble?

O G Titley1, M Cooper, A Thomas

  • 1West Midlands Regional Plastic and Jaw Surgery Unit, Wordsley Hospital.

British Journal of Plastic Surgery
|January 1, 1994
PubMed
Summary
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Bacterial contamination in split-skin grafts negatively impacts graft take. Storage conditions promote bacterial growth, highlighting the need for improved handling protocols in wound care and transplantation.

Area of Science:

  • Dermatology
  • Microbiology
  • Surgical Science

Background:

  • Split-skin grafting is a common surgical procedure for wound coverage.
  • Bacterial contamination of grafts can lead to graft failure.
  • Understanding the relationship between bacterial load and graft success is crucial for optimizing outcomes.

Purpose of the Study:

  • To quantitatively assess bacterial contamination in split-skin grafts.
  • To investigate the correlation between bacterial load and graft take percentage.
  • To evaluate the impact of storage conditions on bacterial proliferation in harvested skin grafts.

Main Methods:

  • Quantitative bacteriology was performed on 102 consecutive split-skin grafts.
  • Skin samples were cultured at the time of harvesting and use.

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  • Cultures were also performed on stored skin unused at 21 days.

    • Main Results:

    • A significant inverse correlation was found between the number of organisms per gram of skin and the percentage of graft take (r = -0.24, p < 0.05).
    • Standard storage conditions were found to promote bacterial multiplication.
    • No significant differences in bacterial contamination were observed across different surgeons, skin preparation methods, graft types, cutting tools, or anesthesia modes.
    • Male patients showed a higher bacterial count in initial grafts (p = 0.02), but this difference diminished after 3 weeks of storage.

    Conclusions:

    • Bacterial load is a significant factor influencing the success of split-skin grafts.
    • Current skin graft storage methods contribute to bacterial growth.
    • Further research into sterile handling and storage techniques is warranted to improve graft survival rates in clinical practice.