Split-thickness skin grafts (STSG), which were first described in the late 1860s,1 remain a widely utilized technique for wound reconstruction; however, harvesting the STSG creates an iatrogenic wound at the donor site. The morbidity associated with this donor site wound (e.g., delayed epithelialization, persistent bleeding, prolonged drainage, and pain) remains a challenge for patients and surgeons, frequently precluding skin grafting and expeditious coverage of the recipient wound. A recent study demonstrated favorable clinical outcomes when using an oxidized regenerated cellulose (ORC)/Collagen/Silver-ORC dressing* to help manage medium-depth STSG donor sites in patients with numerous comorbidities.2 We describe our initial experiences using ORC/Collagen/Silver-ORC dressings on eight donor site wounds in six male and one female patients (n=7), with one male undergoing two independent harvests. Patients ranged in age from 39 to 78 years and had known risk factors for delayed wound healing,3 including obesity, venous insufficiency, peripheral artery disease, hypertension, and malnutrition. After harvesting the STSG from the proximal anterolateral thigh of each patient, ORC/Collagen/Silver-ORC dressings were placed onto the wound and covered with a transparent film dressing. Additional ORC/Collagen/Silver-ORC dressing was applied to the wound weekly, and the semi-occlusive dressing layer was changed weekly and/or as needed. In seven of the eight wounds, complete epithelialization occurred within two weeks. Complete epithelialization occurred within four weeks for the remaining wound. Additionally, the patients expressed minimal pain at the donor site, which historically has been a source of concern. These data provide further support for the use of ORC/Collagen/Silver-ORC dressings to help manage STSG donor sites in patients with known risk factors for impaired wound healing.
*PROMOGRAM PRISMATM Matrix (KCI, now part of 3M Company, San Antonio, TX)
(1) Ang GC. History of skin transplantation. Clin Dermatol 2005;23(4):320-324. doi:10.1016/j.clindermatol.2004.07.013.
(2) Konstantinow A, Fischer TV, Ring J. Effectiveness of collagen/oxidised regenerated cellulose/silver-containing composite wound dressing for the treatment of medium-depth split-thickness skin graft donor site wounds in multi-morbid patients: a prospective, non-comparative, single-centre study. Int Wound J 2017;14(5):791-800. doi:10.1111/iwj.12698.
(3) Guo S, DiPietro LA. Factors affecting wound healing. J Dent Res 2010;89(3):219-229.