A SINGLE CENTRE, RANDOMIZED CONTROL TRIAL OF DONOR SITE WOUND DRESSINGS AFTER SPLIT-THICKNESS SKIN GRAFTING
DOI:
https://doi.org/10.55519/JAMC-04-12318Keywords:
Dressing types, donor site, itching, pain, patient satisfaction, scarring, split-thickness skin grafting, wound healingAbstract
Background: Split-thickness skin grafting (STSG) is a widely employed technique for repairing wounds, such as ulcers, trauma, or in reconstructive surgeries. The objective was to compare the efficacy of different dressing materials for healing donor-site wounds after split-thickness skin grafting. Methods: A single center, randomized controlled trial was conducted at the Department of Plastic Surgery, Civil Hospital Karachi, Pakistan, over a period of six months. The study included patients aged 18 years and above, of both genders, who underwent single donor-site wounds after split-skin grafting with a surface area larger than 10 cm². The eligible patients were randomly divided into six groups: Film, Alginate, Gauze, Hydrofiber, Hydrocolloid, and Silicone. Pain, itching, scarring, complications, and patient satisfaction were evaluated after 12 weeks using standardized assessment scales. Results: The median time to complete wound healing and re-epithelialization varied among the different dressing groups, with hydrofiber and silicone dressings demonstrating the shortest healing time. Statistical analysis revealed a significant difference in the median time to complete wound healing among the dressing groups (p-value=0.019). However, no significant differences were observed in pain, itching, scarring (POSAS observer and patient), or patient satisfaction among the different dressings (p-value>0.05). Conclusion: Although the dressing type did not significantly affect pain, itching, scarring, or patient satisfaction, variations were observed in the time to complete wound healing. These findings contribute to the selection of appropriate donor site dressings for optimizing outcomes in split-skin grafting procedures.References
Prohaska J, Cook C. Skin Grafting. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 July 16]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK532874/
Hahn HM, Jeong YS, Lee IJ, Kim MJ, Lim H. Efficacy of split-thickness skin graft combined with novel sheet-type reprocessed micronized acellular dermal matrix. BMC Surg 2022;22(1):358.
Asuku M, Yu TC, Yan Q, Böing E, Hahn H, Hovland S, et al. Split-thickness skin graft donor-site morbidity: A systematic literature review. Burns 2021;47(7):1525–46. Ref no 3&10 are same
Kamolz LP, Kotzbeck P, Schintler M, Spendel S. Skin regeneration, repair, and reconstruction: present and future. Eur Surg 2022;54(3):163–9.
Brölmann FE, Eskes AM, Goslings JC, Niessen FB, de Bree R, Vahl AC, et al. Randomized clinical trial of donor-site wound dressings after split-skin grafting. Br J Surg 2013;100(5):619–27.
Akhoondinasab MR, Karimi H, Sheikhizadeh S, Saberi M. Reducing pain at split thickness donor sites with silicone dressing compared to petrolatum gauze dressing. Ann Burns Fire Disasters 2019;32(3):210–5.
Darwish AM, Attia AM, Mostafa AAM. Role of amniotic membrane in healing of skin graft donor site. Minia J Med Res 2022;33(1):36–9.
McBride CA, Wong M, Patel B. Systematic literature review of topical local anaesthesia or analgesia to donor site wounds. Burns Trauma 2022;10:tkac020.
Higgins L, Wasiak J, Spinks A, Cleland H. Split-thickness skin graft donor site management: a randomized controlled trial comparing polyurethane with calcium alginate dressings. Int Wound J 2012;9(2):126–31.
Asuku M, Yu TC, Yan Q, Böing E, Hahn H, Hovland S, et al. Split-thickness skin graft donor-site morbidity: A systematic literature review. Burns 2021;47(7):1525–46. Ref no 3&10 are same
Kujur AR, D’Souza NT. Comparison of Three Methods of Dressings for Split Thickness Skin Graft Donor Site-Non Woven Dressing Impregnated with Amorphous Hydrogel, Amorphous Hydrogel with Colloidal Silver and Conventional Paraffin Gauze Dressing. Int J Contemp Med Res 2019;6(12):17–22.
Ron-Doitch S, Kohen R. The Cutaneous Physiological Redox: Essential to Maintain but Difficult to Define. Antioxidants (Basel) 2020;9(10):942.
Sharma DJ, Mishra B, Arora C. In search of ideal donor site wound dressings. Int Surg J 2020;7(9):3012–6.
Kaiser D, Hafner J, Mayer D, French LE, Läuchli S. Alginate dressing and polyurethane film versus paraffin gauze in the treatment of split-thickness skin graft donor sites: a randomized controlled pilot study. Adv Skin Wound Care 2013;26(2):67–73.
Kazanavičius M, Cepas A, Kolaityte V, Simoliuniene R, Rimdeika R. The use of modern dressings in managing split-thickness skin graft donor sites: a single-centre randomised controlled trial. J Wound Care 2017;26(6):281–91.
Koivuniemi R, Hakkarainen T, Kiiskinen J, Kosonen M, Vuola J, Valtonen J, et al. Clinical Study of Nanofibrillar Cellulose Hydrogel Dressing for Skin Graft Donor Site Treatment. Adv Wound Care (New Rochelle) 2020;9(4):199–210.
Ayaz SM, Sadhan G, Ali SI. Evaluation of Effectiveness of Collagen Dressing in Healing of Split Skin graft Donor Site Wound. J Cardiovasc Dis Res 2022;13(8):873–81.
Hu Z, Guo D, Liu P, Cao X, Li S, Zhu J, et al. Randomized clinical trial of autologous skin cell suspension for accelerating re-epithelialization of split-thickness donor sites. Br J Surg 2017;104(7):836–42.
Van den Bergh B, Kruger D, Kourie J, Moeng M, Robson M. A Prospective, Within-Patient Controlled Study to Compare the Ability of the Non Adherent Drawtex® Hydroconductive Dressing to a Transparent Polyurethane Film Dressing (Standard of Care) on the Healing of Split-Thickness Skin Graft Donor Sites*. Surg Sci 2018;09:210–21.
Innes ME, Umraw N, Fish JS, Gomez M, Cartotto RC. The use of silver coated dressings on donor site wounds: a prospective, controlled matched pair study. Burns 2001;27(6):621–7.
Karlsson M, Elmasry M, Steinvall I, Sjöberg F, Olofsson P. Scarring at Donor Sites after Split-Thickness Skin Graft: A Prospective, Longitudinal, Randomized Trial. Adv Skin Wound Care 2020;33(12):1–5.
Hecker A, Lumenta DB, Brinskelle P, Sawetz I, Steiner A, Michelitsch B, et al. A Randomized Controlled Trial of Three Advanced Wound Dressings in Split-Thickness Skin Grafting Donor Sites—A Personalized Approach? J Pers Med 2022;12(9):1395.
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