Debridement with Skin Grafting (Extensive)

Abstract What is a skin graft? A skin graft involves removing a thin layer of skin from an area of the body, such as the thigh or buttocks, and placing it over a new bed of healthy tissue under a burn. This skin then adheres to the wound. The area where the skin is taken from is called the donor site. The location and size of the graft determines how it will be secured, for example with staples, stitches or surgical glue.

What is debridement? Debridement is a procedure that is used to remove the dead skin (or eschar) from the burn area. This procedure is performed under a general anaesthetic in an operating theatre. The burnt area is removed to expose healthy tissue to which the skin graft will be secured.

 1. Introduction Debridement is the removal of unhealthy tissue from a wound to promote healing. It can be done by surgical, chemical, mechanical, or autolytic (using your body’s own processes) removal of the tissue. Skin Grafting may be done if a part of body has lost its protective covering of skin due to burns, injury, or illness. Most skin grafts are done using general anesthesia, which means patient will be asleep throughout the procedure and won’t feel any pain Surgical debridement may be necessary if non-viable tissue is present in a wound; if orally treated osteomyelitis remains unresolved; or if a sinus tract prevents complete wound closure. Post-operative treatment can include immobilization, elevation and antibiotics. Once a non-plantar wound is devoid of all non-viable tissue, healing may be accelerated by a split thickness skin graft or flap. Soft, bulky dressings are often the post-operative dressings of choice. A surgical approach to healing the lower extremity may be considered if previously described conservative treatments are not producing optimal results.  Several routine procedures are occasionally performed and designed to balance bony structures, improve biomechanics or enhance soft tissue for reduction of high pressures during functional ambulation. This is a case of extensive debridement with skin grafting. A female paitient reported at Chandan Hospital, Lucknow complaining about the occurrence of pleural and pericardial effusion with necrotic patches over the right upper limb and swelling over breast.

2. Case History A female patient reported at Chandan Hospital, Lucknow, India was in a state of shock. She had chief complaint of occurrence of pleural and pericardial effusion. The patient also had necrotic patches over the right upper limb and swelling over breast. She was given extensive treatment of debridement with skin grafting.

3. Management The patient presented at the Chandan Hospital in a state of shock with necrotic patches over the right upper limb and swelling over breast with the occurrence of pleural and pericardial effusion. The patient was then followed by Dr. Shree Harsh and underwent initial treatment. During this process, Vacuum Assisted Closure (VAC) was applied and Skin Grafting was done over the right upper limb. She improved significantly both subjectively and objectively and returned to her usual activities.

4. Testimony “I am writing to express my most sincere appreciation for the exceptional experience I had during my entire treatment at Chandan Hospital in Lucknow. The hospital staff and doctors are very responsive and polite. It’s rare that a person leaves a hospital feeling like they are leaving behind friends, but this is one of those moments for me. “

– Pinky (Patient)

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