SURGICAL ASPECTS OF FULL-THICKNESS SKIN AUTOGRAFT ENGRAFTMENT ON A GRANULATING WOUND

Abstract

Background. The paper presents the clinical results of treating patients using full-thickness skin autografts for granulating wounds.Objective. To study the surgical aspects of full-thickness skin autograft engraftment on a granulating wound. Material and methods In traumatology and burn research, to achieve the best cosmetic results, transplantation methods of free full-thickness skin autografts are used. In the Regional Clinical Hospital #1, a method of skin grafting with a full-thickness autograft was developed, which allows to close the defect in the conditions of a purulent wound: granulations are excised before skin transplantation, and a vacuum is applied after grafting.Results. Annually, the specialists of the Burn Center of the Scientific Research Institute – Regional Clinical Hospital #1 assist more than 1300 patients. Of these, from 20 to 25 cases are face burns. 132 patients with burns of the face have been admitted to the hospital over the past 10 years. 37 patients underwent plastic surgery with a full-thickness skin autograft. The authors presented the technology for the surgical treatment of deep burns on the face. After cleansing the wound from areas of necrosis and granulations, usually 20 days after the injury, the upper layers of granulation tissue are removed with a dermatome parallel to the skin surface, to a depth of 1–2 mm. Then, plastic surgery with the free full-thickness skin autograft is carried out on the skin of the face with the formation of cuts for the nose, mouth, eyes. The wound is tightly bandaged with 5–7 rounds of a medical bandage or a vacuum-assisted closure is applied.Conclusion. In case of traumatic skin detachment, plastic surgery according to Krasovitov should be performed in the first hours from the moment of injury. Our study allows transplantation of a full-thickness skin graft to granulating wounds as well. After 5 days, the condition of skin autografts is assessed at the first dressing. Their engraftment is observed on the 7th day. In the postoperative period, scar tissue does not form.