TY - JOUR
T1 - Impact of diabetes and comorbidities on split-thickness skin grafts for foot wounds
AU - Ramanujam, Crystal L.
AU - Han, David
AU - Fowler, Sharon
AU - Kilpadi, Krista
AU - Zgonis, Thomas
PY - 2013/1/1
Y1 - 2013/1/1
N2 - Background: Split-thickness skin grafts can be used for foot wound closure in diabetic and nondiabetic patients. It is unknown whether this procedure is reliable for all diabetic patients, with or without comorbidities of diabetes, including cardiovascular disease, neuropathy, retinopathy, and nephropathy. Methods: We retrospectively reviewed 203 patients who underwent this procedure to determine significant differences in healing time, postoperative infection, and need for revisional surgery and to create a predictive model to identify diabetic patients who are likely to have a successful outcome. Results: Overall, compared with nondiabetic patients, diabetic patients experienced a significantly higher risk of delayed healing time and postoperative complication/infection and, hence, are more likely to require revisional surgery after undergoing the initial splitthickness skin graft procedure. These differences seemed to be related more to the presence of comorbidities than to diabetic status itself. Diabetic patients with preexisting comorbidities experienced a significantly increased risk of delayed healing time and postoperative infection and a higher need for revisional surgery compared with nondiabetic patients or diabetic patients without comorbidities. However, there were no significant differences in outcome between diabetic patients without comorbidities and nondiabetic patients. Conclusions: For individuals with diabetes but without exclusionary comorbidities, splitthickness skin grafting may be considered an effective surgical alternative to other prolonged treatment options currently used in this patient population.
AB - Background: Split-thickness skin grafts can be used for foot wound closure in diabetic and nondiabetic patients. It is unknown whether this procedure is reliable for all diabetic patients, with or without comorbidities of diabetes, including cardiovascular disease, neuropathy, retinopathy, and nephropathy. Methods: We retrospectively reviewed 203 patients who underwent this procedure to determine significant differences in healing time, postoperative infection, and need for revisional surgery and to create a predictive model to identify diabetic patients who are likely to have a successful outcome. Results: Overall, compared with nondiabetic patients, diabetic patients experienced a significantly higher risk of delayed healing time and postoperative complication/infection and, hence, are more likely to require revisional surgery after undergoing the initial splitthickness skin graft procedure. These differences seemed to be related more to the presence of comorbidities than to diabetic status itself. Diabetic patients with preexisting comorbidities experienced a significantly increased risk of delayed healing time and postoperative infection and a higher need for revisional surgery compared with nondiabetic patients or diabetic patients without comorbidities. However, there were no significant differences in outcome between diabetic patients without comorbidities and nondiabetic patients. Conclusions: For individuals with diabetes but without exclusionary comorbidities, splitthickness skin grafting may be considered an effective surgical alternative to other prolonged treatment options currently used in this patient population.
UR - http://www.scopus.com/inward/record.url?scp=84883342634&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84883342634&partnerID=8YFLogxK
U2 - 10.7547/1030223
DO - 10.7547/1030223
M3 - Article
C2 - 23697729
AN - SCOPUS:84883342634
VL - 103
SP - 223
EP - 232
JO - Journal of the National Association of Chiropodists
JF - Journal of the National Association of Chiropodists
SN - 8750-7315
IS - 3
ER -