Background: Split thickness skin graft (STSG) remains
the most common surgical technique to cover skin defects.
However, the healing of its donor area is of paramount importance.
Multiple local drugs are frequently used to enhance its
epithelialization. Systemic Insulin was proved to be beneficial
for chronic wound healing such as pressure sores and diabetic
ulcers. But the impact of local insulin injection was scarcely
studied before as regard wound healing.
Objectives: This study aimed to evaluate the effect of
intradermal insulin injection on the donor of harvested split
thickness skin graft (STSG).
Patients and Methods: In this study, 40 patients; 18 males
and 22 females with skin loss planned to be covered by STSG
were selected. Pregnant, lactating, pre-diabetics and diabetic
patients were excluded. The dimensions of the raw area ranged
from 5-10cm for maximum height and width. The thigh was
used as a donor area and divided by a horizontal line into test
(upper proximal half) and control (lower distal half) areas.
Then, a 10 IU of long-acting insulin (Lantus ®) was intradermally
injected in the test area. Random blood sugar was
measured 6 hours postoperatively. The rate of epithelialization
on days 14 and 21 was analyzed by a special software (Image
J®) and the scar quality was also evaluated by Vancouver
scar scale (VSS).
Results: For the test area, the rate of epithelialization was
significantly faster on days 14 and 21 as compared with the
control area. But there was no statistical difference between
both areas regarding the scar quality when using Vancouver
scar scale.
Conclusion: Intradermal injection of insulin in donor sites
of split thickness skin graft accelerates its healing which
allows early re-harvesting of grafts from same donor sites.