Infection Rates in Split-Thickness Skin Graft Donor Sites in Early Versus Late Exposure Wound Dressing Methods in a Centre, Southeast, Nigeria
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Abstract
Background: Split-thickness skin graft (STSG) donor site wounds are associated with morbidities, including pain, delayed healing, infection, and scaring. In tropical environments, prolonged occlusion with delayed exposure may increase infection risk. This study compared infection rates and healing outcomes between early and late exposure dressing methods for STSG donor sites.
Methods: This prospective comparative study was conducted at Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria, from July 2020 to June 2021. One hundred adult patients requiring STSG were recruited and allocated randomly into two groups of 50 each. Group A had late exposure dressing, while Group B had early exposure and managed with daily application of a mixture of KY jelly and 5% povidone-iodine ointment. Donor site infection, healing rate, and time to complete re-epithelialization, were assessed and compared.
Results: Baseline characteristics were comparable between groups. Mean age was 39 years in Group A and 33 years in Group B. Mean donor site sizes were 111cm2 and 107 cm2, respectively. By postoperative day 14, 70.9% of Group A and 98.2% of Group B achieved complete healing of donor sites. Mean time to complete re-epithelialization was longer in Group A (29.4 days) than in Group B (13.8 days). Donor site infection was 22% in the late exposure group compared to 5% in the early exposure group.
Conclusion: Early exposure dressing significantly reduced donor site infection rates and accelerated healing compared with late exposure dressing, making it preferable donor site management techniques in tropical settings.
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