Background: Split-thickness skin graft (STSG) donor sites sometimes cause more postoperative morbidity for patients than the wound covered with the graft. Yet, there is no consensus on which dressings are best suited to treat these donor sites. Objective: To evaluate two commonly used modern wound dressings in the postoperative healing of STSG donor sites in a prospective randomized controlled trial. Methods: 38 patients were randomly assigned to treatment of an STSG donor site with an alginate dressing or a polyurethane film dressing. The primary outcome measures were postoperative pain scores, secondary outcome variables were time to epithelialization, dressing changes and complications. Results: Postoperative pain on day 1 was significantly lower in the polyurethane film group (2.05 vs. 0.79, p = 0.035) as compared to the alginate group. This difference was not detected on day 5 (0.89 vs. 0.53, p = 0.52). Time to epithelialization did not differ significantly between the two dressing groups. There were more dressing changes in the polyurethane film group and problems with leakage. Conclusion: Whereas film dressings resulted in initially lower pain scores, alginate dressings caused fewer additional dressing changes and less leakage.

1.
Kneilling M, Breuninger H, Schippert W, Hafner HM, Moehrle M: A modified, improved, easy and fast technique for split-thickness skin grafting. Br J Dermatol 2011;165:581-584.
2.
Demirtas Y, Yagmur C, Soylemez F, Ozturk N, Demir A: Management of split-thickness skin graft donor site: a prospective clinical trial for comparison of five different dressing materials. Burns 2010;36:999-1005.
3.
Blome-Eberwein S, Johnson RM, Miller SF, Caruso DM, Jordan MH, Milner S, et al: Hydrofiber dressing with silver for the management of split-thickness donor sites: a randomized evaluation of two protocols of care. Burns 2010;36:665-672.
4.
Cigna E, Tarallo M, Bistoni G, Anniboletti T, Trignano E, Tortorelli G, et al: Evaluation of polyurethane dressing with ibuprofen in the management of split-thickness skin graft donor sites. In Vivo 2009;23:983-986.
5.
Giele H, Tong A, Huddleston S: Adhesive retention dressings are more comfortable than alginate dressings on split skin graft donor sites - a randomised controlled trial. Ann R Coll Surg Engl 2001;83:431-434.
6.
Hormbrey E, Pandya A, Giele H: Adhesive retention dressings are more comfortable than alginate dressings on split-skin-graft donor sites. Br J Plast Surg 2003;56:498-503.
7.
Kilinc H, Sensoz O, Ozdemir R, Unlu RE, Baran C: Which dressing for split-thickness skin graft donor sites? Ann Plast Surg 2001;46:409-414.
8.
Lohsiriwat V, Chuangsuwanich A: Comparison of the ionic silver-containing hydrofiber and paraffin gauze dressing on split-thickness skin graft donor sites. Ann Plast Surg 2009;62:421-422.
9.
Markl P, Prantl L, Schreml S, Babilas P, Landthaler M, Schwarze H: Management of split-thickness donor sites with synthetic wound dressings: results of a comparative clinical study. Ann Plast Surg 2010;65:490-496.
10.
Spear M, Bailey A: Treatment of skin graft donor sites with a unique transparent absorbent acrylic dressing. Plast Surg Nurs 2009;29:194-200, quiz 201-202.
11.
Steenfos HH, Agren MS: A fibre-free alginate dressing in the treatment of split thickness skin graft donor sites. J Eur Acad Dermatol Venereol 1998;11:252-256.
12.
Vaingankar NV, Sylaidis P, Eagling V, King C, Elender F: Comparison of hydrocellular foam and calcium alginate in the healing and comfort of split-thickness skin-graft donor sites. J Wound Care 2001;10:289-291.
13.
Voineskos SH, Ayeni OA, McKnight L, Thoma A: Systematic review of skin graft donor-site dressings. Plast Reconstr Surg 2009;124:298-306.
14.
Geary PM, Tiernan E: Management of split skin graft donor sites - results of a national survey. Clin Plast Surg 2012;39:77-84.
15.
Terrill PJ, Goh RC, Bailey MJ: Split-thickness skin graft donor sites: a comparative study of two absorbent dressings. J Wound Care 2007;16:433-438.
16.
Wiechula R: The use of moist wound-healing dressings in the management of split-thickness skin graft donor sites: a systematic review. Int J Nurs Pract 2003;9:S9-S17.
17.
Dornseifer U, Fichter AM, Herter F, Sturtz G, Ninkovic M: The ideal split-thickness skin graft donor site dressing: rediscovery of polyurethane film. Ann Plast Surg 2009;63:198-200.
20.
Winter GD: Formation of the scab and the rate of epithelization of superficial wounds in the skin of the young domestic pig. Nature 1962;193:293-294.
21.
Malpass KG, Snelling CF, Tron V: Comparison of donor-site healing under Xeroform and Jelonet dressings: unexpected findings. Plast Reconstr Surg 2003;112:430-439.
22.
Rovee DT, Kurowsky CA, Labun J: Local wound environment and epidermal healing. Mitotic response. Arch Dermatol 1972;106:330-334.
23.
Madden MR, Nolan E, Finkelstein JL, Yurt RW, Smeland J, Goodwin CW, et al: Comparison of an occlusive and a semi-occlusive dressing and the effect of the wound exudate upon keratinocyte proliferation. J Trauma 1989;29:924-930, discussion 930-931.
24.
Vogt PM, Andree C, Breuing K, Liu PY, Slama J, Helo G, et al: Dry, moist, and wet skin wound repair. Ann Plast Surg 1995;34:493-499, discussion 499-500.
25.
Katz MH, Alvarez AF, Kirsner RS, Eaglstein WH, Falanga V: Human wound fluid from acute wounds stimulates fibroblast and endothelial cell growth. J Am Acad Dermatol 1991;25:1054-1058.
26.
Leipziger LS, Glushko V, DiBernardo B, Shafaie F, Noble J, Nichols J, et al: Dermal wound repair: role of collagen matrix implants and synthetic polymer dressings. J Am Acad Dermatol 1985;12:409-419.
27.
Pirone LA, Bolton LL, Monte KA, Shannon RJ: Effect of calcium alginate dressings on partial-thickness wounds in swine. J Invest Surg 1992;5:149-153.
28.
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;26:67-73.
29.
Chaby G, Senet P, Vaneau M, Martel P, Guillaume JC, Meaume S, et al: Dressings for acute and chronic wounds: a systematic review. Arch Dermatol 2007;143:1297-1304.
30.
Gottrup F, Apelqvist J, Price P: Outcomes in controlled and comparative studies on non-healing wounds: recommendations to improve the quality of evidence in wound management. J Wound Care 2010;19:237-268.
31.
Woo KY, Sibbald RG: The improvement of wound-associated pain and healing trajectory with a comprehensive foot and leg ulcer care model. J Wound Ostomy Continence Nurs 2009;36:184-191, quiz 192-193.
32.
Disa JJ, Alizadeh K, Smith JW, Hu Q, Cordeiro PG: Evaluation of a combined calcium sodium alginate and bio-occlusive membrane dressing in the management of split-thickness skin graft donor sites. Ann Plast Surg 2001;46:405-408.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.