Management of Diabetic Ulcer With Composite Skin Graft - A Case Report
Madhavi Banarase , B.N.Deshpande
1 Assistant Professor, 2 Professor & H.O.D , Department of Shalya Tantra, College of Ayurved & Research Centre, Akurdi, Pune (Maharashtra), India.
Corresponding Author: Madhavi Banarase
E-mail: dr.madhavibanarase209@gmail.com
Submission: 31.10.2018 Acceptance: 17.12.2018 Publication: 15.02.2019
https://www.doi.org/10.63778/PDEASIJRAAS-ARJCPL/2019_21541
Abstract:
Introduction: Surgery is one of the important branch of Ayurveda. Acharya Sushruta, the ancient Indian Surgeon is recognised as the father of plastic surgery. Sushruta made important contributions to the field of plastic surgery. Skin grafting is a surgical procedure that involves removing the skin from one area of the body and moving it, or transplanting it, to a different area of the body. Skin grafting is often used to treat extensive wounding caused by trauma, burn, necrotising fasciitis, after excising skin cancer etc. Also it helps to cover diabetic ulcer. Case Presentation: An eighty five years male patient had come with non-healing ulcer at heel of right foot since two months. There was an ulcer with unhealthy granulation tissue with slough at its floor, edges were undermined, necrosed. Foul smell discharge was there.
Management and Outcome: The wound was debrided thoroughly. The edges were excised. All necrotic tissue was removed. So there was an extensive bare area, and to cover this raw area composite graft from sural area was used. This graft was selected along with skin and underling tissue allowing its vascular supply remained intact. It was sutured. To cover the raw area of this donor site split skin grafting was performed.
Discussion- This case report proved that to manage extensive wounding due to diabetes, when primary closure was contraindicated, skin grafting showed wound healing without any contracture under control of blood sugar. Key Words: Diabetic ulcers, Plastic surgery, Skin grafting, Necrotising Fasciitis, Skin Cancers, Debridement
Conclusion: It shows that extensive skin loss requires skin grafting to promote fast healing of wound and to avoid contracture. In diabetes also it helps in wound healing under control of blood sugar.