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EVALUATION OF SKIN GRAFT VIABILITY WITH AND WITHOUT SURGICAL REMOVAL OF GRANULATION TISSUE IN SKIN AND SOFT TISSUES DEFECT
*Zen Afif MD and Firas Melhem MD, PHD
Background: Grafts are currently the predominant method of open wounds reconstruction. Various techniques are being practiced in skin grafts but little information is available regarding the best method. Objective: The aim of this study was to evaluate the results of skin grafts in closure of various defects with or without surgical removal of granulation tissue. Patients and Methods: A Comparative Prospective study conducted for the period one year (May 2020 – May 2021) at Tishreen University Hospital in Lattakia-Syria. The study included two groups of patients were compared: group I consisted of 16 patients (53.3%)who underwent skin grafting without granulation tissue surgical removal, whereas group II consisted of 14 patients (46.7%) who underwent skin grafting with surgical removal of granulation tissue. Results: A total of 30 patients, 20 males (66.7%) and 10 females (33.3%) with a median age of 44 years were included in the study. Trauma was the most frequent etiology of defects in 15 cases (50%), and extremities were the most affected parts of the body in 18 cases (60%). 56.7% of the patients were smokers, and split-thickness grafts were the most frequent type of applied grafts in 21 cases (70%). There were no significant differences between two groups regarding demographic variables except of age (33.50±19.4 in group I versus 50±17.21 in group II, p:0.02). The duration of recovery was significantly shorter in group I (14.06±3.7 versus 16±2.5 in group II, p:0.04). The rate of complication in group I was 18.8% which included: seroma (6.25%), partial graft necrosis (6.25%), and complete graft necrosis (6.25%) versus 21.4% in group II which included partial graft necrosis (14.3%), and complete graft necrosis (7.1%) without significant difference, p:0.8. Factors that associated with longer duration of recovery in group I were: age older than 18 years (p:0.04), smoking(p:0.001), and defects located on trunk (p:0.01). All patients in group II were older than 18 years and recovery time increased with increasing age (r:0.48, p:0.01), and presence of smoking was associated with longer time(p:0.002). Conclusion: The current study demonstrated favorable results in skin grafts viability when closing the skin defects with two techniques, with significantly shorter duration of recovery in patients who underwent grafting without surgical removal of granulation tissue compared with the other group.[Full Text Article]