Comparison of Skin Graft Donor Site Management Using Oxidized Regenerated Cellulose (ORC)/Collagen/Silver-ORC With Absorptive Silicone Adhesive Border and Transparent Film Dressing Versus Semi-Occlusive Dressings

Topics: 

Abstract

Background: Split-thickness skin grafts (STSG) are widely used in wound reconstruction.1 However, during the STSG procedure, a donor site wound is created, requiring additional wound care.2 A combination of moist wound healing and transparent film dressings have been shown to provide positive clinical outcomes for donor site wounds.3,4 A retrospective comparison of dressing use between oxidized regenerated cellulose (ORC)/collagen/silver-ORC dressing (ORC/C/Ag-ORC)* with an absorptive silicone adhesive border dressing and transparent film dressing (Treatment) and semi-occlusive dressing (Control)over donor site wounds was conducted.

Methods: Patients underwent STSG procedure between January and December 2020. Donor sites received either ORC/C/Ag-ORC, an absorptive silicone adhesive border dressing, and a breathable, transparent film dressing (Treatment group, n=10) or semi-occlusive dressing only (Control group, n=10). Dressing changes occurred as necessary. Time to epithelialization, narcotic pain medication requirement, and number of office/hospital visits were examined.

Results: Twenty patients presented for care (9 males, 11 females, average age: 49.7 ± 13.9 years). Patient comorbidities included hypertension, diabetes, and hyperlipidemia. Wound types included trauma, infectious, and cancer excision. Donor size was larger in the treatment group, though this was not statistically significant. Time to epithelization was significantly reduced in the treatment group (11.1 ± 1.4 days vs 18 ± 2.4 days, p

Conclusions: In this patient population, use of ORC/C/Ag-ORC, an absorptive silicone adhesive border dressing, and breathable, transparent film dressing resulted in shorter time to epithelization and lesser narcotic pain medicine requirement compared to the semi-occlusive dressing use.

*PROMOGRAN PRISMA Matrix, †KERRAFOAM™ Gentle Border Dressing, ‡BIOCLUSIVE™ Plus Transparent Film Dressing (Systagenix Wound Management, Ltd, Gargrave, UK)

References:

  1. Janis JE, Kwon RK, Attinger CE. The new reconstructive ladder: modifications to the traditional model. Plas Reconstruct Surg. 2011;127(Suppl 1):205S-212S.
  2. Chowdhry SA. Use of oxidized regenerated cellulose (ORC)/collagen/silver-ORC dressings to help manage skin graft donor site wounds. JPRAS Open. 2019;22:33-40.
  3. Brown JE, Holloway SL. An evidence-based review of split-thickness skin graft donor site dressings. Int Wound J. 2018;15(6):1000-1009.
  4. Serebrakian AT, Pickrell BB, Varon DE, et al. Meta-analysis and Systematic Review of Skin Graft Donor-site Dressings with Future Guidelines. Plast Reconstruct Surg - Global Open. 2018;6(9):e1928.

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