Effect of Subcutaneous Adrenaline/Saline/Lidocaine Injection on Split-Thickness Skin Graft Donor Site Wound Healing

DOI 機関リポジトリ Web Site 参考文献16件
  • Fukuoka Kohei
    Department of Plastic and Reconstructive Surgery, Tottori University Hospital, Yonago 683-8504, Japan
  • Yagi Shunjiro
    Department of Plastic and Reconstructive Surgery, Tottori University Hospital, Yonago 683-8504, Japan
  • Suyama Yoshiko
    Department of Plastic and Reconstructive Surgery, Tottori University Hospital, Yonago 683-8504, Japan
  • Kaida Wataru
    Department of Plastic and Reconstructive Surgery, Shimane Prefectural Central Hospital, Izumo 693-0068, Japan
  • Morita Maki
    Department of Plastic and Reconstructive Surgery, Tottori University Hospital, Yonago 683-8504, Japan
  • Hisatome Ichiro
    Department of Genetic Medicine and Regenerative Therapeutics, Institute of Regenerative Medicine and Biofunction, Graduate School of Medical Sciences, Tottori University, Yonago 683-8503, Japan

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<p>Background Subcutaneous injection of tumescent solution, which contains local anesthetic, adrenaline, and saline, before split-thickness skin graft harvesting, shows a significant hemostatic effect. This method can reduce the initial bleeding from the donor site. The aim of this study is to assess the benefits of controlling the bleeding from donor sites by tumescent injection. A randomized, controlled trial was performed to compare the wound healing of split-thickness skin graft donor sites treated with or without tumescent injection.</p><p>Methods This randomized, controlled trial examined donor site healing days as the main measure of outcome. postoperative pain, donor site ulceration, and scar quality were evaluated as secondary outcome measures. Patients planned for split-thickness skin graft harvest were randomly assigned to receive either pre-harvest subcutaneous injection of local anesthetic, adrenaline, and saline solution (tumescent solution) (Group 1) or post-harvest application of adrenaline solution-soaked gauze to the skin graft donor sites (Group 2). Donor sites were treated with calcium alginate dressings after graft harvesting. On the 10th postoperative day, the dressings were removed and donor site healing were measured. Follow-up evaluation of scar quality was performed 6 months after surgery. Postoperative pain was evaluated on the 1st day after operating.</p><p>Results Forty-five patients (26 males; average age 61.8 years) completed the late follow-up evaluation (6 months postoperatively), with 26 patients in group 1 and 19 in group 2. There were no significant differences between the two groups in any of the outcome measures.</p><p>Conclusion Tumescent technique provides sufficient hemostasis in split skin graft donor sites, especially the initial bleeding just after graft harvesting, without any negative effects. Larger series should be studied to evaluate the effect in donor site wound healing.</p>

収録刊行物

  • Yonago Acta Medica

    Yonago Acta Medica 64 (1), 107-112, 2021

    ヨナゴ・アクタ・メディカ刊行会

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