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The Effect of Local Insulin Injection on the Healing Process of Split Thickness Skin Graft Donor Site: A Randomized, Double-Blind, Placebo Control Clinical Trial Publisher



Abianeh SH1 ; Bajestani SM1 ; Rahmati J1 ; Shahrbaf MA2 ; Shirzad N3
Authors
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Authors Affiliations
  1. 1. Department of Plastic and Reconstructive Surgery, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Department of Plastic and Reconstructive Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

Source: European Journal of Plastic Surgery Published:2020


Abstract

Background: Wound site coverage by a split-thickness skin graft (STSG) is an effective technique after reconstructive surgery. Previous studies have been suggested that insulin is a stimulator for skin wound healing. This study was aimed to determine the effect of local insulin injection on the improvement of STSG donor site wound healing. Methods: A randomized clinical trial was performed in patients undergoing STSG in 2019. The donor site of patients was divided into control and case segments. Two cubic centimeters of NPH insulin was injected at the case segment with a concentration of 1 IU/ml and normal saline was injected at the control segment by the same volume. The wound site epithelialization area was calculated by ImageJ® software at the 7th, 14th, and the 21st day after the intervention. The epithelialization area of the case and control group was compared by SPSS software. Results: Epithelialization area was improved at the 21st day compared to 14th day and 7th day. In addition, the amount of epithelialization was significantly higher at the case segment in the 7th, 14th, and the 21st day after the injection with the P values of 0.006, 0.001, and < 0.0001, respectively. Moreover, there was not any sign of hypoglycemia and other complications in patients. Conclusion: Subdermal injection of insulin may improve the wound site epithelialization in the post-operative period. Level of evidence: Level I, therapeutic study. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.