Use of Oxidized Regenerated Cellulose (ORC)/Collagen/Silver-ORC Dressings for Skin Graft Donor Sites

Split thickness skin grafts (STSG), which were first described in the late 1860s¹, 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 (eg, 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 8 donor site wounds in 6 male and 1 female patients (n=7), with 1 male undergoing 2 independent harvests. Patients ranged in age from 39 to 78 years and had known risk factors for delayed wound healing³, 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 7 of the 8 wounds, complete epithelialization occurred within 2 weeks. Complete epithelialization occurred within 4 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)

Reference
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.