A Study on Aerobic Bacteriological Profile of Pregrafted Wounds and Its Effect on Success Rate of Split Thickness Skin Grafting

Geetha Banu, S (2017) A Study on Aerobic Bacteriological Profile of Pregrafted Wounds and Its Effect on Success Rate of Split Thickness Skin Grafting. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION: Chronic non healing wounds pose a significant burden to healthcare systems and also cause morbidity and mortality to patients. Split Thickness Skin Grafting (STSG) is one of the main surgical procedures to repair soft tissue loss in nonhealing chronic wounds. Grafting should be done only onto a well-vascularised viable and uninfected wound surface, such as granulating tissue. Hence proper wound bed preparation is the mainstay of successful skin grafting. AIM OF THE STUDY: To determine the quantitative aerobic bacterial culture of pre-grafted wounds and its influence on graft uptake. MATERIALS AND METHODS: A bit of tissue was collected from the pre-grafted wound bed of patients who were prepared for STSG surgery, under aseptic precautions and processed by aerobic quantitative bacteriological culture method. Post operatively 2 wound swabs were taken from patients with reduced graft uptake and semi-quantitative bacterial culture was done. Antibiogram of the isolates was done using Kirby-Bauer disk diffusion method. RESULTS: Among 100 patients who were prepared for STSG, 32 patients had significant bacterial growth with bacterial counts ≥ 10⁵CFU/g of tissue in pre-operative aerobic quantitative culture. 7 patients had growth with bacterial counts ≤ 10⁴CFU/g of tissue. The most common pathogens isolated in pre-operative quantitative culture were Staphylococcus aureus (26.4%) and Pseudomonas aeruginosa (26.4%). The graft uptake was reduced to 78.32% when pre-op quantitative bacterial count was ≥ 10⁵CFU/g of tissue, which was statistically significant. The mean graft uptake was reduced by 24.5% if immediate preoperative culture showed Staphylococcus aureus and mean graft uptake reduced by 31.2% if immediate pre-operative culture showed Pseudomonas aeruginosa when compared to the no growth group. There was statistically significant correlation between pre-operative diabetic status of the patient, duration of ulcer and graft uptake failure. CONCLUSION: The effect of bacteria on wound healing thus depends on the bacterial bioburden in the wound, the virulence of the bacteria and also on the host factors. Hence for a better uptake of Split thickness skin grafts, quantitative and qualitative bacteriological culture of chronic non healing wounds that are prepared for skin grafting can be performed before surgery to determine the severity of infections in the wound bed, thereby preventing graft failure.

Item Type: Thesis (Masters)
Additional Information: Reg.No.201314003
Uncontrolled Keywords: Split thickness skin grafting (STSG), wound bed, Quantitative bacterial culture, Semi-quantitative bacterial culture, Graft uptake.
Subjects: MEDICAL > Microbiology
Depositing User: Subramani R
Date Deposited: 18 Jul 2020 17:25
Last Modified: 19 Jul 2020 04:29
URI: http://repository-tnmgrmu.ac.in/id/eprint/12546

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