Publication:

Bacterial colonization of leg ulcers and its effect on success rate of skin grafting

Background Leg ulceration is a common condition that affects many individuals. It is often treated by split skin graft. The aim of the study is to estimate the effect of bacterial colony on the skin graft and to evaluate the effects of diabetes and age on wound healing.

Methods This is a prospective study of 50 patients who underwent SSG for leg ulcer in KIMS from June 2018 to May 2020. All patients underwent blood tests for diabetes and wound swabs were taken preoperatively and 5th post-operative day (POD). SSG take-up assessed on 8th POD.

Results 62% of cultures were positive, of which Staph. aureus 48%, Klebsiella 6% Acinetobacter 4%, Citrobacter and E. Coli 2%. During the culture taken on 5th POD (1st dressing), Staphylococcus aureus was found in 42% of patients, and other bacteria put together 24%. Regarding take up, ulcers with Staphylococcus aureus had significantly reduced graft take up when compared to no growth, both during pre-op culture test and 5th POD dressings, by 24.18 and 33.165% respectively. The length of hospital stays for patients with positive Staphlycoccus aureus either in pre-operative or 5th POD swab was more by 15.25 compared to no growth.

Conclusions For patients with Staphylococcus aureus on the ulcer, graft take up is less and post op stay is long, so, eradication of Staphylococcus aureus is essential. For patients with other bacteria, did not have significant difference with no growth group.