A Prospective Study on Return of Protective Tactile Sensations in Split-Thickness Skin Grafts

Abstract

In the long evolution of world surgery, split-thickness skin grafting has distinguished itself as an age-old clinical tool utilised for soft tissue coverage. However, the scanty endorsement of return of protective tactile sensations in these split-thickness skin grafts seems mired between therapeutic subservience and clinical necessity. The objective of this study was to evaluate recovery of tactile protective sensations in split-thickness skin grafts. A total of 100 patients were recruited for the study. Prospective analysis of demographics, pre- and post-operative variables was done to evaluate the return of tactile sensations by two-point discrimination and cotton touch. Males represented 69% of the patients with a mean age of 49.04 (± 16.34) years. Early recovery of two-point discrimination at the periphery of the split-thickness skin graft was observed in 1 week in 23.9% and cotton touch in 61.4% of patients. Over a follow-up period of 1 year, 60% patients had recovery of two-point discrimination and 92.8% for cotton touch. The return of sensation at the centre of the graft was delayed and at 1-year follow-up, 67% developed tactile sensations. The rate of change of two-point discrimination with respect to time was significant (F = 5.74, P = 0.018). Delayed recovery of sensations was observed in patients who developed graft bed oedema or had a scarred graft bed. The encouraging early return of tactile sensation furnishes the split-thickness skin graft with a protective capability against shear, often offered as a reason for graft loss in contemporary wisdom. The findings of a delayed return in a scarred and oedematous graft bed can be expressed as clinical underpinnings and these observations should expand the myriad uses a split thickness skin graft can be put to in soft tissue coverage.