• Dun-Hao Chang, Yi-Ting Lin, Che-Wei Chang, Yo-Shen Chen, Chi-Ying Hsieh, and Ke-Chung Chang.
• Division of Plastic and Aesthetic Surgery, Department of Surgery, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, Banqiao District, New Taipei City, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taiwan; Department of Information Management, Yuan Ze University, Taiwan. Electronic address: jchang50002000@yahoo.com.tw.
• Burns. 2022 Sep 1; 48 (6): 139614041396-1404.

PurposeTo provide evidence of efficacy and postoperative benefit of topical anesthesia (TA) for harvesting split-thickness skin graft (STSG) in an Asian population.Materials And MethodsPatients with well-granulating wounds with skin grafting were randomized into TA or general anesthesia (GA) groups. In the TA group, an eutectic mixture of lidocaine and prilocaine (EMLA) was applied. Perioperative heart rate, postoperative donor site pain, adverse effects, patients' satisfaction, duration of surgery, and operation room (OR) stay duration were recorded.ResultsThirty-nine patients (19 males, 20 females; mean age 54.9 ± 17.8) were included. Twenty underwent TA and 19 underwent GA for STSG. The TA group patients had tolerable pain during skin graft harvesting (VAS, 0.85 ± 1.5). Average EMLA exposure duration was 180.3 ± 65.8 min, and the amount applied was 1.72 ± 0.43 g/10 cm2. The TA group had lower donor site pain score at one hour postoperatively (1.34 ± 1.49 vs 3.08 ± 1.90, p = 0.005), lower OR stay duration (36.5 ± 6.5 min vs 65.1 ± 17.2 min, p < 0.001) and less adverse effects than the GA group.ConclusionHarvesting STSG under TA with EMLA is an effective and efficient approach for most Asian patients with less early postoperative donor site pain and fewer adverse effects.Copyright © 2021 Elsevier Ltd and ISBI. All rights reserved.

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