Donor Site Morbidity in Skin Grafting: A Comparative Study of Cobbett Knife and Zimmer Electric Dermatome
Famous Dickson Ukpebor
Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.
Emmanuel E. Esezobor
Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.
Oluwafemi O. Awe
Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.
Friday Emeakpor Ogbetere *
Department of Surgery, Faculty of Clinical Sciences, Edo University, Iyamho Edo State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Skin grafting in many low resource centres is mostly harvested with Humby Knife and its various modifications. However, there is a gradual paradigm shift to the use of the electric dermatome. This study aimed to compare the rate of re-epithelialization of donor site wound, pain index, and scar formation using Cobbett Knife with Zimmer electric power dermatome in harvesting partial thickness skin grafts.
Materials and Methods: The study comprised 76 patients recruited over a one year period. The patients were randomized into two groups (A and B) using systematic sampling. Those in group A had their donor site harvested with Cobbett Knife, while those in group B had their donor site harvested with Zimmer electric power dermatome. The predictive variables were the percentage rate of re-epitheliliazation, assessment of pain index, and scar formation. The outcome variable was to use a photographic picture on the 10th, 14th, and 21st day respectively to assess the rate of re-epithialization. A Numerical rating scale was employed to assess the pain index.
Results: There was no significant difference in the donor site morbidities between Cobbett knife and Zimmer electric dermatome in the percentage rate of re-epithelialization and evaluation of scar formation with a P-value of 0.304 and 0.416 respectively. However, data analysis of donor site pain between Cobbett knife and Zimmer electric dermatome was statistically significant with a P- value of 0.042 and 0.031 respectively, in patients with mild pain at the 6th hour and 3rd day. There was no statistically significant difference on the 10th day with a p- value of 0.857.
Conclusion: From this study, the use of the Cobbett knife for the harvest of partial thickness skin graft is comparably the same as Zimmer electric power dermatome in terms of re-epitheliazation and scar formation. However, Cobbett knife is associated with more intense early post-operative pain compared to Zimmer electric power dermatome.
Keywords: Donor site, Cobbett knife, morbidity, Zimmer electric power dermatome, partial thickness skin graft