Anandaravi B.N.1, Manjunath R.D.2, Puneeth D.N.3
BACKGROUND
The study was started with the aim to determine take up rate in tumescent
technique compared to non-tumescent technique for harvesting split skin graft.
Tumescent technique has been practiced for over forty years especially in
liposuction. Tumescent anaesthesia is a combination of crystalloid, lignocaine,
adrenaline and sodium bicarbonate. Using tumescent local anaesthesia for
harvesting a split thickness skin graft is not in much practise. This study was
designed to provide strong evidence of this technique.
METHODS
This was an observational study. Two treatment groups of patients, tumescent
(group A, N = 21) and non-tumescent technique (group B, N =21), who fulfilled
the inclusion criteria were randomly assigned. Tumescent technique involved
administration of Klein’s formula. No prior administration of agent was performed
in non-tumescent technique. The recipient site was opened in both groups on the
fifth day after surgery and take rate assessed.
RESULTS
The difference in take up rate between the two groups was found to be statistically
significant. Compared to the patients in group B, patients who underwent
tumescent technique (group A) had higher take up rate (> 12 %, P = 0.005). We
did not find any statistically significant difference in donor site percentage healing
between the tumescent and non-tumescent groups, P = 0.379.
CONCLUSIONS
Tumescent technique gives better take up results and is more effective than nontumescent
technique in harvesting split skin graft. The subdermal injection creates
a smooth, dense surface which assists donor harvesting. This can be implemented
preoperatively in split-thickness skin grafting.
