Outcomes and Postoperative Complications Following Debridement and Split-Thickness Skin Grafting for Lower Limb Wounds: A Case Series of 30 Patients from a Tertiary Care Institution

Abstract

Background: Lower limb wounds are an enormously high surgical burden, especially when complicated by infection and trauma or systemic comorbidities. Surgical debridement and split-thickness skin grafting (STSG) has been one of the keys to wound reconstruction. However, graft uptake and functional results are still affected by complications after surgery.

Case Presentation: This case series presents 30 patients treated in a tertiary care institution and who underwent surgical debridement of the wounds on the lower limbs and subsequently STSG. Patients ranged in age from 22 to 68 years of age and included wounds secondary to trauma, diabetic foot disease, post-infective necrosis and chronic non-healing ulcers. Comprehensive clinical evaluation, microbiologic assessment and optimization of comorbid conditions predicted operative intervention. All patients were subject to serial debridement until a healthy granulating wound bed was established, then STSG harvested from the thigh and applied over the wound and outcomes were documented.

Interventions and Outcomes: Postoperative results were analysed in reference to: graft uptake; wound healing time; infection; graft loss; haemorrhage; and donor site morbidity. Complete uptake of the graft was seen in 21 patients (70%). Partial graft loss occurred in six patients (20%) and complete graft failure occurred in three patients (10%). The most common complications observed after the operation were surgical site infection (16.7%), formation of seroma or hematoma (13.3%), and delayed healing of incision (20%). Patients with diabetes mellitus and peripheral vascular disease showed higher rate of complications.

Conclusion: Debridement followed by STSG remains an effective reconstructive option for lower limb wounds. However, postoperative complications are influenced by systemic comorbidities, wound etiology, and local wound conditions. Careful patient selection, meticulous surgical technique, and vigilant postoperative monitoring are critical to optimizing outcomes.