title: Outcomes for split-thickness skin transplantation in high-risk patients using octenidine.
abstract: 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.
authors.affiliation: Department of Plastic, Aesthetic and Reconstructive Surgery, Wilhelminenspital, Vienna, Austria.|Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Matiasek
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Austria.|Department of Plastic and Aesthetic Surgery, Reconstructive and Hand Surgery, St. Markus Hospital, Frankfurt, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Djedovic
authors.affiliation: Department of Plastic, Aesthetic and Reconstructive Surgery, Wilhelminenspital, Vienna, Austria.
authors.forename: L
authors.initials: L
authors.lastname: Unger
authors.affiliation: Department of Plastic, Aesthetic and Reconstructive Surgery, Wilhelminenspital, Vienna, Austria.
authors.forename: H
authors.initials: H
authors.lastname: Beck
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Mattesich
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Austria.
authors.forename: G
authors.initials: G
authors.lastname: Pierer
authors.affiliation: Department of Plastic, Aesthetic and Reconstructive Surgery, Wilhelminenspital, Vienna, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Koller
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Austria.|Department of Plastic and Aesthetic Surgery, Reconstructive and Hand Surgery, St. Markus Hospital, Frankfurt, Germany.
authors.forename: U M
authors.initials: UM
authors.lastname: Rieger
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D006085:Graft Survival; D006801:Humans; D007097:Imines; D007866:Leg; D008297:Male; D008545:Melanoma / Q000601:surgery; D008875:Middle Aged; D009336:Necrosis / Q000601:surgery; D054843:Negative-Pressure Wound Therapy; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D011205:Povidone / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use*; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D012086:Reoperation; D012307:Risk Factors; D016038:Skin Transplantation / Q000009:adverse effects*; D012907:Smoking / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000209:etiology*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
chemical_list: D000305:Adrenal Cortex Hormones; D000891:Anti-Infective Agents, Local; D007097:Imines; D011725:Pyridines; D011205:Povidone; C034213:octenidine
keywords: antiseptic wound management; cortisone therapy; diabetes mellitus; octenidine; split-thickness skin graft; tie-over dressing