Split thickness skin graft donor site morbidity – patients’ perspective

Sarah Bache¹, Lisa Martin^2,3, Michal Nessler¹, Danielle Malatzky ¹, Andrew Frank¹, Helen Douglas¹, Suzanne Rea¹, Fiona Wood^1,2,
¹State Adult Burns Unit Of Western Australia, Perth/Murdoch, Western Australia, Australia
²Fiona Wood Foundation, Perth, Western Australia, Australia
³University of Western Australia, Perth, Western Australia, Australia

Abstract

Aim: A survey was conducted to ask burn patients their opinions about donor site problems they encountered following a STSG.
Methods: A customized questionnaire was created with input from the multidisciplinary team and patients. A cohort of 250 patients who had a STSG for an acute burn between August 2020 and July 2021 was identified and the survey conducted via a mobile phone link. Patients’ demographics and details from surgical procedures were obtained from electronic records. Regression analysis was performed to determine factors that could contribute to an improved experience of the donor site.
Results: The response rate was 43%. Data from 107 patients with STSG donor sites between 12 and 30 months old was analyzed. According to 70% of respondents, their donor site looked the same or about the same as their normal skin. The commonest early complication was itch (51%), and late complication was dyspigmentation (32%). Pigmentation differences were more often reported by women and individuals with higher Fitzpatrick skin types. Patients with super-thin grafts (0.003-0.005 inch) were less likely to have stiff, thicker scars and abnormal sensation at the donor site than those with thick (0.006-0.008 inch).
Conclusions
This study provides an important view of patients’ donor site morbidity that may influence the informed consent process and the surgeons’ decision on the thickness of the harvested STSG.

Biography

Dr Michal Nessler is a consultant plastic surgeon from Poland, who holds the position of Burns Fellow at State Adult Burns Unit of Western Australia. He has over 15 years of clinical experience in clinical burns treatment both in adults and children. His main research interests are skin substitutes and scar-less healing.