Early outcome and associated factors of split thickness skin grafting at Muhimbili National Hospital Dar es salaam Tanzania

Abstract

ABSTRACT Introduction Split-thickness skin grafting is the most basic technique for transferring tissue which consists of epidermis plus a variable thickness of dermis from the donor site to the recipient site for the purpose of covering the wound to allow fast healing. Factors contributing to STSG outcome include age, sex, comorbidities, smoking, medications, wound size, wound site, first day of wound dressing post-surgery, hematoma, seroma and wound infection. There is paucity of information regarding outcome and factors contributing to STSG outcome in our settings. Aim of this study; Assessment of early outcome and associated factors of split thickness skin grafting at Muhimbili National hospital. Methodology; Prospective cohort study design conducted at MNH involving patients admitted in burn and plastic surgery unit. Data were collected using Swahili version questionnaires and analysis was done using SPSS Version 23. Cumulative incidence was calculated and risk ratio was used to measure association of the graft and variables. Multivariable logistic regression was used to control potential confounders. Any variable showed association with P value < 0.05 was considered as independent predictors. Results: The study involved 100 study participants. The median age of the participant was 25yrs with interquartile range (IQR) of 34yrs. 58% of the participants were male. 12% of the study participants had comorbidities.5% were on chronic drugs use, 1% of the participant had infected graft and 1% had hematoma on lower limbs. Cumulative incidence of STSG failure was 12%. Factors associated with skin graft outcome were age, peripheral vascular disease and source of wound. Burn source of wound was found to be independent predictor for skin graft failure. Conclusion: Incidence of skin graft failure was 12% among patients who underwent STSG at Muhimbili National Hospital. Burn wound was independent predictor for STSG failure.