Long Term Outcomes of Split-Thickness Skin Grafting to the Plantar Foot

Elliot T. Walters, Mira Pandya, Neha Rajpal, Michel M. Abboud, Tammer Elmarsafi, John S. Steinberg, Karen K. Evans, Christopher E. Attinger, Paul J. Kim

Research output: Contribution to journalArticle

Abstract

The most common consequence of neuropathy is a diabetic foot ulcer, which usually occurs on the plantar surface of the foot. Split-thickness skin grafting (STSG) has been shown in numerous studies to be an effective treatment for rapid coverage of diabetic ulcers. The purpose of this study is to retrospectively examine the outcomes of STSG to the plantar foot and determine the durability of this treatment compared to non–plantar surface STSG. This is a retrospective, single-center, institutional review board approved, case-control study of all patients who received STSG to their lower extremity for chronic ulcers from November 2013 to February 2017. Patients with ulcers on the plantar surface were considered cases, and non–plantar surface ulcers were considered controls. There were 182 patients who received STSG to the lower extremity, 52 to the plantar surface foot and 130 to non–plantar surface locations. Healing at 30 days was not significantly different between plantar and nonplantar ulcers (19% versus 28%, p = .199) but did become significant at 60, 90, and 365 days (21% versus 45%, p = .003; 33% versus 49%, p = .043; 38% versus 64%, p = .002, respectively). However, time to full healing was not significantly different between plantar and nonplantar groups (18.2 ± 19.5 versus 17.4 ± 21.6 weeks, mean ± standard deviation, p = .84). Recurrence was low for both groups (17% versus 10%, respectively), and there was no significant difference between groups (p = .17). Patients with plantar surface ulcers can achieve a durable coverage/closure of their wounds with STSG. When combined with appropriate patient selection and postoperative offloading, acceptable recurrence rates can be achieved.

Original languageEnglish (US)
Pages (from-to)498-501
Number of pages4
JournalJournal of Foot and Ankle Surgery
Volume59
Issue number3
DOIs
StatePublished - May 1 2020

Keywords

  • diabetes
  • diabetic foot ulcer
  • neuropathy
  • wound
  • wound healing

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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    Walters, E. T., Pandya, M., Rajpal, N., Abboud, M. M., Elmarsafi, T., Steinberg, J. S., Evans, K. K., Attinger, C. E., & Kim, P. J. (2020). Long Term Outcomes of Split-Thickness Skin Grafting to the Plantar Foot. Journal of Foot and Ankle Surgery, 59(3), 498-501. https://doi.org/10.1053/j.jfas.2019.09.027