A comparison of skin storage methods for oculoplastic surgery

Abstract

Purpose: To assess the level of contamination of full-thickness skin grafts stored with or without an antibiotic cover.

Methods: Full-thickness skin grafts were harvested from 40 bilateral upper lid blepharoplasties. Before surgery the face was sterilised, the head of the patient was packed with sterile, single-use surgical drapes and the whole face was left exposed. The harvested full-thickness skin grafts were conserved in sterile containers at 4 degrees C for 6 days, rolled in gauze moistened with either 4 ml of sterile saline solution (group I) or with 4 ml of gentamicin solution (2 mg/ml) (group II). The degree of contamination, expressed in colony forming units (CFU), was evaluated on days 2, 3, 4, 5 and 6. Identification of the microorganisms was done to species level following standard procedures and commercial methods.

Results: In group I 2 grafts (5%) were negative during the whole observation period while the other 38 grafts (95%) presented a degree of contamination ranging from 10(2) to 10(4) CFU. Microorganisms isolated were: Staphylococcus epidermidis (24 cases), Staphylococcus aureus (5 cases), Staphylococcus saprophyticus (2 cases), Pseudomonas aeruginosa (4 cases), Serratia liquefaciens (1 case) and Klebsiella oxytoca (2 cases). In group II, 26 grafts (65%) were negative during the whole observation time while in 14 cases (35%) a few colonies (3 to 6) of Candida albicans were isolated on day 2 and remained constant in number for the whole observation time.

Conclusions: The storage of full-thickness skin graft with an antibiotic cover is more reliable than the storage of full-thickness skin graft without an antibiotic cover.