Outcome of split-thickness skin graft (STSG) in complex orthopaedic trauma.

Abstract

Objective: Complex orthopedics wounds are challenges to surgeon and patient in operative management. Road traffic accidents, the major cause of open fracture, represent a massive global health problem with high mortality and morbidity rates. Study Design: Retrospective study. Setting: Ghurki Trust Teaching Hospital, Lahore. Period: January 2021 to January 2022. Material & Methods: Thirty eight patients with open fractures with skin loss, treated with graft, and wound where a flap was not possible were included in the study. The outcome was assessed in terms of the outcome of STSG in complex orthopaedic trauma. Results: A total of 38 patients were included who underwent STSG graft. Among these, more than half of cases, 33(86.8%), were males, while 5(13.2%) were female cases with a mean age of 25.82±13.09 ranging from (6-63) years. Graft loss was found in 4 cases (10.5%), graft contracture in 7 cases, altered sensation in three cases, skin pigmentation in 4 cases, episode infection in 8 cases, and skin breakdown in only one case observed. Average hospital stay ranged from 2-3 weeks in all cases. Conclusion: It is concluded that Acute complex orthopedics wounds present a unique challenge for surgeons. Good surgical technique, early appropriate surgical intervention, source control, early use of broad-spectrum antibiotic therapy, VAC dressing, and early tissue coverage prevent wound infection and decrease the chances of limb amputation.