Abstract
The ultimate goal of wound care is to obtain wound closure either by natural process or by use of surgical technique and so all the steps need to be taken with a plan to reach the goal at the earliest. While performing skin grafting, closure of the existing wound is the aim, but the procedure also creates another wound (though superficial), causes pain, and may have healing issues. Optimal bed preparation is mandatory to obtain successful uptake of skin graft and to avoid loss of precious skin autograft. Every wound has its own unique needs and demands. Different agents and methods are often needed to meet these demands. It is essential to accrue experience and develop insight into the efficacy, utility, and advantages of different approaches for wound bed preparation. The availability, cost of the method, socioeconomic status of the patient, type of health care system, ease of access to facility, expertise—all these and many other factors play a role in deciding the choice of method for wound bed preparation. It is possible that different methods may be developed, evaluated, and found to be useful in different countries or different parts of the same country too. The author has evaluated methods spread over a wide spectrum including indigenously prepared topical agent, barrier foam dressing prepared using advanced technology, porcine xenografts which are not available in India, and skin allografts from the very first skin bank in India set up by the author and colleagues. The experience shared here looks at the ability of the method to control infection, inflammation, pain besides the time taken to achieve effective wound bed preparation and frequency of dressing change needed, along with ease of training.