Full-Thickness Skin Grafting in the Management of Wide Post-Drainage Lesions of Non

Full-thickness skin grafting in the management of wide post-drainage lesions of non weight- bearing surfaces of the foot. A. Piaggesi, L. Rizzo, M. Pieri*, A. Tedeschi, S. Nardi*, F. Palumbo, F. Campi, A. Scatena, C. Goretti, S. Del Prato. Department of Endocrinology and Metabolic Diseases, Section of Diabetic Foot, and * Anesthesiology Department, University of Pisa. Italy

Aim of the Study: To evaluate the effectiveness and safety of autologous skin grafting in the management of wide post-operative lesions of diabetic foot Patients and Methods: All the diabetic patients with non-ischemic (ABPI>0.8), non-infected, granulating post-operative lesions of the dorsum and margins of the foot due to infections’ drainage, wider than 10 cm2 followed in our department during the year 2004 were randomized in two different groups: group A [N 17, 12DM2/5DM1, age 63.1±7.8 yrs, Duration of Diabetes (DD) 21.4±12.7 yrs, HbA1c 8.9±1.7%] was left to heal for secondary intent according to our standard procedures with hydrofiber dressing, while group B [N 18, 14DM2/4DM1, age 59.8±9.1 yrs, DD 17.2±11.4 yrs, HbA1c 9.4±2.2%] was submitted to autologous full-thickness skin grafting, performed in loco-regional anaesthesia. The following parameters were evaluated: healing time, calculated from the drainage intervention, healing rate in six-month follow-up, number of infective complications, taking of skin grafts, time for re-epithelialization of donor site. Results: Results are reported in the table Group A Group B P Area of lesions (cm2) 21.6±9.8 24.2±11.3 n.s. Healing rate (%) 79.6 88.9 <0.05 Healing time (days) 211.6±88.4 98.7±21.7 <0.01 Infections (n) 7 2 <0.05 Taking of graft (%) 75.5±15.5 ------Donor site (days) 15.8±6.5 ------Conclusions: Despite previous controversial reports, in our hands autologious skin grafting have been demonstrated to be a safe and effective therapeutic option for wide post-surgical lesions of non-weight bearing surface S of the foot in the reparative phase; it fasten healing time reducing the length of the reparative phase and reduces the infective complications as well