Aim: The aim of this study was to evaluate the benefits and risks of local infiltration in split-thickness skin grafts donnor site with ropivacaine (Naropein.
Materials and methods: Therefore a prospective study was conducted enrolling 30 patients assessed for split skin grafts to cover muscular flaps, burn areas or primary tumor sites. Donnor site surface ranged from 50 to 200 cm(2). Patients were randomized into two groups: with or without infiltration. Critters of inclusion were age over 18 y.o., donnor site surface below 200 cm(2), no neurological or psychiatic pathology, no contra-indication to ropivacaine. All grafts were performed under general anaesthesia, using Lagrot's razor to take 0.2 to 0.4 mm thickness skin bands. Donnor sites dressings were standardized, associating a corticoid fat dressing (Corticotulle strongly and occlusively contained with an elastic band (Elastoplast. Dressings were removed after three weeks. Immediate and late post-operative pain were evaluated using analogic visual scale (EVA) and need of analgesics during the hospitalisation in our Institution. Side-effects were collected.
Results: Thirty patients were enrolled in this prospective study. They were mean aged 37 years old, sex ratio was 1/1. Donor site surface was mean 157 cm(2) and graft thickness 0.35 mm. There was a significant difference in immediate and late post-operative pain between both groups. Ropivacain reduced pain for the same oral analgesics use during 36 to 48 post-operative hours. No difference was noticed after 48 hours. No side-effects were noticed.
Conclusion: Infiltration of split skin grafts donnor site with ropivacain improves postoperative pain during 48 hours. This is a safe and efficient method to improve comfort in addition to a standardized occlusive dressing. It has become a standard routine in our Institution.