A comparison of skin storage methods for oculoplastic surgery

Area of Science:

• Ophthalmology and reconstructive surgery
• Microbiology
• Tissue banking and preservation

Background:

• Full-thickness skin grafts are utilized in reconstructive surgery, necessitating reliable preservation methods.
• Contamination during storage can compromise graft viability and patient outcomes.
• Assessing microbial contamination is crucial for ensuring the safety and efficacy of stored skin grafts.

Purpose of the Study:

• To evaluate and compare the microbial contamination levels of full-thickness skin grafts stored with or without antibiotic cover.
• To determine the effectiveness of gentamicin in preventing bacterial and fungal growth in stored skin grafts.

Main Methods:

• Full-thickness skin grafts from 40 blepharoplasty procedures were harvested and stored at 4°C for 6 days.
• Grafts were preserved in sterile gauze moistened with either sterile saline (Group I) or gentamicin solution (Group II).
• Microbial contamination was assessed by colony-forming units (CFU) on days 2, 3, 4, 5, and 6, with species identification.

Main Results:

• Group I (saline): 95% of grafts showed contamination (10^2 to 10^4 CFU), with common bacteria including Staphylococcus epidermidis and Staphylococcus aureus.
• Group II (gentamicin): 65% of grafts remained negative; 35% had minimal Candida albicans growth (3-6 colonies) from day 2 onwards.
• Gentamicin significantly reduced bacterial contamination, with only a minor presence of fungal growth observed.

Conclusions:

• Storage of full-thickness skin grafts with antibiotic cover (gentamicin) is significantly more reliable than storage in saline.
• Antibiotic-treated grafts demonstrate a substantially lower risk of microbial contamination, enhancing their suitability for clinical application.