COMPARISON OF TUMESCENT AND NON-TUMESCENT TECHNIQUES IN SPLIT-THICKNESS SKIN GRAFT HARVESTING: AN OBSERVATIONAL COMPARATIVE STUDY OF 90 CASES

Abstract

Background: Split-thickness skin grafting (STSG) is a cornerstone reconstructive procedure. The tumescent technique—subdermal infiltration of a dilute lidocaine–adrenaline solution—may reduce intra-operative blood loss and improve graft outcomes, but comparative evidence, particularly in the Indian population, is limited.

Objective: To compare early graft uptake, donor site healing, and short-term outcomes between tumescent and non-tumescent STSG harvesting.

Methods: In this observational comparative study, 90 patients requiring STSG were grouped according to the technique received—Group A (tumescent, n = 45) or Group B (non-tumescent, n = 45). A blinded assessor measured graft uptake on day 5, donor site healing on day 10, and final healing at 3 weeks by planimetry of standardized photographs. Continuous variables were compared by independent-samples t-test and categorical variables by chi-square or Fisher's exact test (p < 0.05 significant).

Results: Mean graft uptake on day 5 was significantly higher in the tumescent group (96.2 ± 4.8% vs. 92.1 ± 5.2%; p < 0.001), as was donor site healing on day 10 (98.4 ± 2.6% vs. 95.3 ± 3.1%; p < 0.001). At 3 weeks, outcomes were comparable (97.8 ± 2.4% vs. 97.1 ± 2.6%; p = 0.19).

Conclusion: The tumescent technique offers superior early graft uptake and donor site healing, while final outcomes at 3 weeks are comparable. Both techniques are safe and effective.