Table of Contents
Plastic Surgery International
Volume 2012, Article ID 715273, 6 pages
http://dx.doi.org/10.1155/2012/715273
Review Article

The Use of Split-Thickness Skin Grafts on Diabetic Foot Ulcerations: A Literature Review

Division of Podiatry, Beth Israel Deaconess Medical Center, 185 Pilgrim Road Baker 3, Boston, MA 02215, USA

Received 2 September 2011; Revised 5 December 2011; Accepted 4 January 2012

Academic Editor: Bishara S. Atiyeh

Copyright © 2012 Brant McCartan and Thanh Dinh. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Diabetic foot ulcerations are historically difficult to treat despite advanced therapeutic modalities. There are numerous modalities described in the literature ranging from noninvasive topical wound care to more invasive surgical procedures such as primary closure, skin flaps, and skin grafting. While skin grafting provides faster time to closure with a single treatment compared to traditional topical wound treatments, the potential risks of donor site morbidity and poor wound healing unique to the diabetic state have been cited as a contraindication to its widespread use. In order to garner clarity on this issue, a literature review was undertaken on the use of split-thickness skin grafts on diabetic foot ulcers. Search of electronic databases yielded four studies that reported split-thickness skin grafts as definitive means of closure. In addition, several other studies employed split-thickness skin grafts as an adjunct to a treatment that was only partially successful or used to fill in the donor site of another plastic surgery technique. When used as the primary closure on optimized diabetic foot ulcerations, split-thickness skin grafts are 78% successful at closing 90% of the wound by eight weeks.