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A Journal on Physiopathology and Therapy of Chronic Cutaneous Ulcers
Official Journal of the Italian Association for Cutaneous Ulcers
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Acta Vulnologica 2015 September;13(3):135-43
language: English, Italian
Integrated surgical-complex decongestive physiotherapy protocol for the stabilization of skin graft repair in the leg
Nicoletti G. 1, 2, Corda D. 3, Jaber O. 4, Pellegatta T. 4, Tresoldi M. M. 4, Scalise A. 5, Faga A. 1, 2
1 Unit of Plastic Surgery, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy;
2 Unit of Plastic Surgery, Salvatore Maugeri Research and Care Institute, Pavia, Italy;
3 Polimedica San Lanfranco, Pavia, Italia;
4 School of Specialization in Plastic Reconstructive Esthetic Surgery, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy;
5 Clinic of Plastic Reconstructive Surgery, Università Politecnica delle Marche, Ancona, Italy
AIM: A late skin graft failure often follows a successful engraftment at one week’s time and such a complication is always associated with clinical objective signs of lymphatic stasis at the site of the graft. Post-traumatic recovery in the lymphatic circulation usually is more difficult than in the blood circulation and it is favored by phisio-kinesitherapy allowing matrix decongestion. The authors present the clinical outcomes from the association of complex decongestive physio-kinesitherapy and surgery in the management of skin graft repair on the leg after excision of skin tumors (30) or unstable scars (28) in a sample of 58 patients.
METHODS: The complex decongestive physiotherapy was carried out according to 2 modalities: 1) in the edematous leg both a pre-operative and a postoperative treatment were scheduled, the latter starting 1 week after surgery at the time of the patient mobilization and hospital discharge; 2) in the non-edematous leg only a postoperative treatment was scheduled starting 1 week after surgery at the time of the patient mobilization and hospital discharge.
RESULTS: A stable wound healing was appreciated in all of the cases at the 6 month follow-up.
CONCLUSION: The complex decongestive physiotherapy allows for the skin graft stabilization on the leg and therefore it has been included in our routine postoperative skin graft management protocol and in the pre-operative preparation of the edematous leg scheduled for skin graft repair.