A Study Evaluating the Uptake of Split-Thickness Skin Grafts in Relation to the Initial Postoperative Dressing Applied on Day Third Versus Day Fifth

Abstract

Skin grafting is a technique used to restore the continuity of the skin. The primary reasons for the failure of skin grafts include seroma, haematoma, or infection. These issues hinder the adherence of the graft and its revascularization, leading to a higher likelihood of graft rejection, especially in the early postoperative phase. Aim: The goal of the study was to analyses graft acceptance, rejection resulting from infection or seroma, and the timing of the first postoperative dressing on day third compared to day fifth. A comparative and prospective study was carried out at our institution from November 2021 to April 2024, involving 200 patients who received split-thickness skin grafting (STSG) and were divided into two groups. In Group A, the initial postoperative dressing was applied on day 3, while for Group B, it was done on day 5. The second postoperative dressing took place two days after the first. The grafted area was evaluated for the percentage of graft uptake, incidence of seroma, rejection, and infection, both through clinical observation and culture sensitivity testing. Findings revealed that the average graft uptake in group A was 88.5%, compared to 81.93% in group B during the first dressing, while during the second dressing, group A showed 88.24% and group B showed 78.03%, with the data being statistically significant, indicating a lower rate of rejection and infection in group A. Seroma occurred in 82.01% of cases in group A and 74.02% in group B during the first postoperative dressing, decreasing to 6.0% and 12.0%, respectively, by the second dressing. Performing the first postoperative dressing on third day after skin grafting significantly enhances the final graft uptake and decreases the rejection rate by minimizing both seroma and infection.