SALVAGING SKIN FROM AMPUTATED LIMB: AN OVERLOOKED DONOR - OUR EXPERIENCE FROM LEVEL I TRAUMA CENTER subodh6@gmail.com

 

SALVAGING SKIN FROM AMPUTATED LIMB: AN OVERLOOKED DONOR - OUR EXPERIENCE FROM LEVEL I TRAUMA CENTER

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India

Oral only

Trauma is a leading cause of amputation in developing countries. At our centre, 368 patients underwent amputation during the study period. Preserving adequate stump length and initiating early rehabilitation are vital for optimal outcomes in amputees.

This retrospective observational study reviewed patients who underwent split-thickness skin graft (STSG) harvesting and preservation from amputated limbs between December 2021 and August 2024. Data were sourced from the institutional graft register and electronic medical records, focusing on demographics, amputation type, graft preservation duration, usage, and outcomes. Grafts were preserved short-term at 4°C in saline-moistened or paraffin gauze, with unused grafts discarded after 21 days.

Skin grafts were harvested from 105 limbs of 99 patients, mostly above-knee amputations (n=71, 68%). Of these, 62% (n=62) were discarded due to non-utilization. Around 17% were used as autografts for stump coverage, and 20% were applied as allografts. The average time to use autografts was 8 days, and 15 days for allografts. Auto grafts used after 14 days resulted in rejection in all cases, while only 23% of those used within 14 days were rejected.

STSG’s are crucial for covering amputation stumps when primary closure isn’t feasible due to trauma or infection. They preserve stump length, facilitating rehabilitation and reducing energy expenditure for prosthetics. However, grafting has its complications. To address this, we harvest and preserve skin from amputated limbs using a simple, cost-effective short-term preservation technique. These preserved grafts can also be used as allografts for other patients if needed reducing costs and optimizing medical resources.