The role of recruited minced skin grafting in improving the quality of healing at the donor site of split-thickness skin graft-A comparative study.

INTRODUCTION: The donor area of split thickness skin graft harvest usually takes 2-3 weeks to heal. A few studies have shown that application of minced skin grafting helps to reduce this time. The objective of this comparative study was to find the role of recruited minced skin grafting on the overall quality of healing at the split thickness skin graft donor area. MATERIALS AND METHODS: The study included 30 patients undergoing split thickness skin graft for acute traumatic wounds. We selected two donor areas of nearly equal size on medial and lateral side of either thigh in each case. They were randomly allocated to control area and study area using an envelope technique. Minced graft was applied over the study area. Same dressing and post operative care were done for both the areas. RESULTS: In our study we found average time for complete epithelialization at control area was 28.17+/-5.590days whereas it was 21.93+/-2.420days in the study area. The earlier epithelialisation time of study area compared to control area was significant on statistical analysis. Vancouver scar scale (VSS) comparison at third month and one year follow up showed significant difference of scores (1 versus 0) as the scars were hypopigmented at control area and comparatively better pigmented at study area. We found visual analogue score for Pain and pruritus to be better for study area at the end of first, second and third month. CONCLUSION: In this study we conclude that, recruited minced skin grafting to the donor site of split skin graft leads to better quality of healing in terms of early epithelialisation, better quality of scar, better pigmentation, less pain and pruritus, thus leading to improved quality of healing.

Bipedicled scalp flaps for reconstruction of high-tension electric burns of calvarium.

High-tension electrical calvarial burns are extremely rare and difficult to reconstruct. Invariably, these are third- or fourth-degree-deep burns involving the bone and underlying brain. Historically, these wounds have been treated conservatively, adding to morbidity and prolonged treatment. Two patients with high-tension electrical calvarial burns presented to us 2 weeks after the injury, one fourth-degree deep with infected necrotic calvarium and scalp, resulting in a full-thickness frontoparietal defect with herniation of the brain. The other patient had third-degree burns over the occiput with surrounding second-degree-deep burns extending onto the nape of the neck with patches of second-degree deep burns over the vertex. Both patients had the risk for being subjected to prolonged anesthesia. The defects were covered with bipedicled scalp flap. In the face of sepsis and other comorbidities where more complicated flaps are risky, this flap provides a simple and reliable method of reconstruction.