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A Novel Technique of Collagen Application over Meshed Split Thickness Graft for Wound Coverage

Naveen Narayan,Ravi Shivaiah,Kamal M Kumar.


Abstract

Background: Skin thickness skin (STSG) grafting is an indispensable technique in a plastic surgeon’s armamentarium. However, a limited donor option for harvesting skin grafts to cover large surfaces poses a problem. Meshing of STSG solves this to certain extent but often leads to undesirable results such as cobblestone/snake skin appearance, pain and slows healing. This research aims to study the results of a novel technique of using collagen over meshed STSG with regard to type of wounds amenable for this technique, pain relief, operative outcome, recovery time and cost.

Methods: All types of wound amenable for STSG requiring meshing were included in the study. Collagen sheet was placed over the meshed graft to cover the windows of meshed graft. Patients were assessed for post-operative pain relief, recovery time, final appearance, texture & pliability and cost effectiveness of the treatment.

Results: All the patients in the study had minimal / no pain. Interval between dressing change was longer. No infection or graft loss was observed. Treatment cost was reduced since overall hospital stay and number of dressing change required lessened. The grafted area was smooth with acceptable appearance and structure. Formation of cobblestone / snake skin appearance was reduced significantly.

Conclusion: Our novel technique of using collagen sheet over meshed STSG is unique in that it comprises use of autologous skin and biological dressing in the same procedure. As observed in the results this technique has produced a very favorable outcome. However it requires evaluation of procedure in a large cohort.

Key words: Mesh, Surgical; Grafting, Skin; Biologic Dressing; Collagen; Wounds






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