Reconstruction
Conditions
Keywords
donor site, thick split-thickness skin graft, thin split-thickness skin graft, reconstruction
Brief summary
In clinical settings, split-thickness skin graft (STSG) remain the gold standard for covering large skin defects. However, STSGs usually bring complications to the donor sites. The study objective was to compare the efficacy of thick split-thickness skin graft versus thin split-thickness skin graft in the reconstruction of the donor site.
Detailed description
All patients were randomly divided into two groups. For the patients in the thick STSG group, the surgeons harvested thick STSGs which were larger than recipient sites. The extra skin was punctured and stretched to cover the donor site (the novel technique). For the patients in the thin STSG group, the surgeons harvested thick STSGs of the size of recipient sites. Their donor sites were covered with thin STSGs which were harvested from other parts of the patients. The 36-item short form health survey (SF-36) scores, pain scores, pruritus scores, scar scores and rates of complications were compared between the two groups.
Interventions
PROCEDUREthick STSG; thin STSG
For all the patients, thick STSGs (at a depth of 0.7 mm) were harvested from the upper lateral thighs to repair skin defects at functional sites or joint sites. For patients in the thick STSG group, the surgeons harvested a larger size of thick STSGs than the size of recipient sites. The size of the donor site was 150% - 200% of the size of the recipient site. Part of the thick STSG was grafted onto the recipient site. Subsequently, the leftover skin was punctured (in 1.5:1 mesh ratio) and stretched to obtain expansion. The donor site was covered by the leftover skin completely. In other words, the donor site was reconstructed by resurfacing the large sheet of thick STSG in situ. For patients in the thin STSG group, the surgeons harvested thick STSGs of the size of recipient sites. Their donor sites were covered with a large sheet of thin STSGs (at a depth of 0.4 mm) which were harvested from other parts of the patients.
Sponsors
Nanjing First Hospital, Nanjing Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
(1) Patients had skin defects at functional sites or joint sites; (2) Patients aged 20-80 years; (3) The lateral thighs were chosen as the donor sites.
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Patients had skin defects at functional sites or joint sites. 2. Patients aged 20-80 years. 3. The lateral thighs were chosen as the donor sites.
Exclusion criteria
1. Patients who were unable to complete the follow-up. 2. Pregnant or nursing mothers were not included. 3. Patients had an alternative source of pain other than surgical sites. 4. Patients with organ dysfunctions (heart failure, respiratory failure, liver dysfunction, renal impairment or intestinal failure), or cancers. 5. Patients with autoimmune diseases (rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, Sjogren's syndrome, connective tissues disease or systemic vasculitis) were not included. 6. Patients who had medications (such as corticosteroids, immunosuppressive agents or chemotherapy) within six months were not included. 7. Other reasons.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| healing time of the donor sites | 2 months post surgery | The complete healing time of the donor sites was defined as the day when 100% epithelialization was achieved, |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| life quality (36-item short form health survey scores) | Prior to surgery or at 6 months post-surgery | The life quality of patients was evaluated by the 36-item short form health survey (SF-36) scores (including General Health scores, Mental Health scores, Social Function scores, and Vitality scores). The minimum value is 0. The maximum value is 100. The higher score means a better outcome. |
| pains scores (Visual Analogue Scales) | on Day 1 and Day 7 postoperatively | The degrees of pain at the donor sites were evaluated by the Visual Analogue Scales. Patients were asked to score levels of pain (0 = no pain, 5 = worst pain) using Visual Analogue Scales. The higher score means a worse outcome. |
| pruritus scores | at 3 months and at 6 months post-surgery | The degrees of pruritus at the donor sites were measured by scores (1 = never or occasional itches, 2 = itches do not disturb sleep, 3= itches disturb sleep). The higher score means a worse outcome. |
| scars scores ( Vancouver Scar Scales ) | at 3 months and 6 months post-surgery | The scar formation at the donor sites were evaluated with the Vancouver Scar Scales (from 0 to 15, 0 = best and 15 = worst) in terms of pigmentation, vascularity, pliability and height. The higher score means a worse outcome. |
Countries
China
Contacts
Primary ContactYin Wu, phD
Outcome results
None listed