Comparative study of STSG over any wound with and without surgical removal of granulation tissue | ||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||
| Articles in Press, Accepted Manuscript, Available Online from 17 September 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejprs.2025.406637.1438 | ||
| Authors | ||
| Harshavardhan Rokde; Deepak Patil* ; Riya Vakil; Santosh Thorat; Anand Zingade; Mayur Baviskar | ||
| Department of General Surgery, Pimpri Chinchwad Municipal Corporation's Postgraduate Institute, Yashwantrao Chavan Memorial Hospital, Pimpri, Pune - 411018, Maharashtra, India | ||
| Abstract | ||
| Background: Split-thickness skin grafting (STSG) is a widely practiced technique for wound coverage, particularly in chronic wounds. Traditionally, surgical debridement of granulation tissue is performed prior to STSG to ensure optimal graft adherence. However, emerging evidence suggests that preserving healthy granulation tissue may be equally effective while minimizing operative trauma. Objective: To compare the outcomes of STSG performed with and without surgical removal of granulation tissue, focusing on graft take, healing time, intraoperative blood loss, and cosmetic results. Methods: This retrospective comparative study included 40 patients with chronic wounds undergoing STSG between January 2022 and December 2024 at a tertiary care center in Pimpri-Chinchwad, Pune. Patients were divided into two groups: Group A (n=20) underwent surgical debridement of granulation tissue prior to grafting, while Group B (n=20) received grafts directly over intact healthy granulation tissue. Outcomes assessed included graft take percentage on postoperative day 15, intraoperative blood loss, healing time, and cosmetic deformity. Results: Graft take was comparable between the groups (97.66% in Group A vs. 96.47% in Group B; p=0.058). Healing was slightly faster in Group B (19.15 vs. 20.15 days; p=0.056). Intraoperative blood loss was lower in the non-debridement group (97.70 ml vs. 101.86 ml; p=0.318). Cosmetic outcomes were better in the non-debridement group, though not statistically significant. Conclusion: Preserving healthy granulation tissue before STSG offers comparable outcomes to conventional debridement with potential benefits in healing time and aesthetics, supporting a selective, tissue-sparing approach in suitable patients. | ||
| Keywords | ||
| Split-thickness skin graft; granulation tissue; wound healing; debridement; cosmetic outcome | ||
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