Outcomes for split-thickness skin transplantation in high-risk patients using octenidine.
Skin transplantation is a commonly used surgical technique; however, the complication rate, including postoperative infection and delayed wound healing due to inefficient perfusion, is significantly higher in patients suffering from comorbidities. Hence, a subsequent repeat procedure is often necessary. In this report, two case studies are presented in which an octenidine-based antiseptic is used with a tie-over dressing (TOD) instead of povidone iodine (PVP-iodine), following a split-thickness skin graft. The two patients selected were deemed to be at high risk of impaired wound healing due to comorbidities. The first patient, a confirmed smoker with diabetes, presented with a nodular melanoma that was resected and covered with a split-thickness skin graft. After 5 days of negative pressure wound therapy as a TOD, in combination with PVP-iodine, the graft became necrotic. A second split-thickness skin graft was performed and an antiseptic regimen with octenidine in combination with the same TOD resulted in a completely healed transplant. The second patient, also a confirmed smoker with diabetes and receiving oral corticosteroid treatment, was diagnosed with a skin necrosis on her leg. Following the split-thickness skin graft, octenidine and TOD were applied. The patient's skin graft completely healed without any adverse events. These two case studies indicate that the combination of octenidine and TOD following split-thickness skin transplantation is safe, well-tolerated and appears to have positive benefits in the reconstruction of defects in patients with impaired wound healing.
['Matiasek|J|J|', 'Djedovic|G|G|', 'Unger|L|L|', 'Beck|H|H|', 'Mattesich|M|M|', 'Pierer|G|G|', 'Koller|R|R|', 'Rieger|U M|UM|']
D000305:Adrenal Cortex Hormones D000369:Aged, 80 and over D000891:Anti-Infective Agents, Local D003924:Diabetes Mellitus, Type 2 D005260:Female D006085:Graft Survival D006801:Humans D007097:Imines D007866:Leg D008297:Male D008545:Melanoma D008875:Middle Aged D009336:Necrosis D054843:Negative-Pressure Wound Therapy D011183:Postoperative Complications D011205:Povidone D011725:Pyridines D019651:Reconstructive Surgical Procedures D012086:Reoperation D012307:Risk Factors D016038:Skin Transplantation D012907:Smoking D013530:Surgical Wound Infection D016896:Treatment Outcome D014945:Wound Healing
octenidine tie-over dressing split-thickness skin graft antiseptic wound management cortisone therapy diabetes mellitus