title: ﻿Use of Cadaveric Donor Skin to Predict Success of a Definitive Split-thickness Skin Graft in Complicated Wounds﻿﻿﻿﻿﻿﻿﻿.
abstract: ﻿﻿﻿﻿﻿Split-thickness skin grafts (STSG) are used for covering large wound beds. This procedure is sometimes postponed due to a positive culture swab. In those cases, prolonged antibiotic therapy is advised. The present study shows that if a temporary cadaveric donor skin has good take, antibiotic therapy is not necessary and a normal STSG can be performed directly with acceptable results.
  
  
  METHODS
  Cadaveric donor skin was applied in 35 consecutive patients. If the cadaveric donor skin had a good take (adherence) to the wound bed, the patient was scheduled for a STSG. In cases where the cadaveric donor skin failed to take, the definitive skin graft procedure was postponed. In six consecutive cases the cadaveric donor skin was evaluated for possible pathological changes.
  
  
  RESULTS
  In 25 out of 35 patients the cadaveric donor skin had full take. In 22 of these 25 patients a STSG was performed, which led to 91% complete graft take rate. These patients were not treated routinely with antibiotics and if they were treated, surgery was not postponed.
  
  
  CONCLUSIONS
  Delaying STSG while waiting for swab culture results is not necessary if the cadaveric donor skin has good take 3 days after application; in such cases, the take (attachment) of a STSG in a complicated set of patients is > 90%. The cadaveric donor skin, with positive take, showed more granulocytic influx in the epidermal layer and more vitality than those with no adherence to the wound bed. Vascular in-growth was not noted in any of the cases ﻿.
authors.affiliation: ﻿Leiden University Medical Centre, Department of Surgery, Leiden, The Netherlands; Email:s.a.stegeman@lumc.nl﻿﻿
authors.forename: Sylvia A
authors.initials: SA
authors.lastname: Stegeman
authors.forename: Louk P
authors.initials: LP
authors.lastname: van Doorn
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Calame
authors.forename: Pascal
authors.initials: P
authors.lastname: Steenvoorde