Split-thickness skin grafts to the foot and ankle of diabetic patients

Kyle Sanniec, Tea Nguyen, Suzanne van Asten, Javier La Fontaine, Lawrence A. Lavery

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations


Background: There is an increased prevalence of foot ulceration in patients with diabetes, leading to hospitalization. Early wound closure is necessary to prevent further infections and, ultimately, lower-limb amputations. There is no current evidence stating that an elevated preoperative hemoglobin A1c (HbA1c) level is a contraindication to skin grafting. The purpose of this review was to determine whether elevated HbA1c levels are a contraindication to the application of skin grafts in diabetic patients. Methods: A retrospective review was performed of 53 consecutive patients who underwent split thickness skin graft application to the lower extremity between January 1, 2012, and December 31, 2015. A uniform surgical technique was used across all of the patients. A comparison of HbA1c levels between failed and healed skin grafts was reviewed. Results: Of 43 surgical sites (41 patients) that met the inclusion criteria, 27 healed with greater than 90% graft take and 16 had a skin graft that failed. There was no statistically significant difference in HbA1c levels in the group that healed a skin graft compared with the group in which skin graft failed to adhere. Conclusions: Preliminary data suggest that an elevated HbA1c level is not a contraindication to application of a skin graft. The benefits of early wound closure outweigh the risks of skin graft application in patients with diabetes.

Original languageEnglish (US)
Pages (from-to)365-368
Number of pages4
JournalJournal of the American Podiatric Medical Association
Issue number5
StatePublished - Sep 2017

ASJC Scopus subject areas

  • Podiatry
  • Orthopedics and Sports Medicine


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