Split-thickness skin graft donor sites: a comparative study of two absorbent dressings.
OBJECTIVE
To identify the optimal dressing for split-thickness skin graft (SSG) donor sites.


METHODS
This prospective randomised controlled trial compared two dressings - a new absorbent form of a polyurethane film dressing (Tegaderm Absorbent, 3M) and our standard alginate dressing (Kaltostat, ConvaTec) - on SSG donor sites in 40 patients. Primary outcome measures were: reduced time to full healing; reduced postoperative pain; reduced leakage rates from the dressing. Secondary outcome measures related to acceptability of the dressings to the patient.


RESULTS
On removal of the dressings at the first assessment, 79% of the Tegaderm Absorbent donor sites had healed completely, compared with 16% of the Kaltostat ones (p<0.001).A significantly greater median area had healed with Tegaderm Absorbent (100%), when compared with Kaltostat (89%) (p<0.001). Mean time to complete healing was also significantly faster for Tegaderm Absorbent than Kaltostat (14 versus 21 days) (p<0.001). Significantly fewer subjects experienced postoperative pain with Tegaderm Absorbent on both day 1 (21% versus 67%, p=0.006, NNT=3) and day 2 (17% versus 75%, p<0.001, NNT=2). Leakage rates reduced by 48% with Tegaderm Absorbent, with no leakage in the smaller donor sites. Tegaderm Absorbent was significantly easier to apply than Kaltostat (89% versus 27% found it'very easy') as was ease of removal (84% versus 11% found it'very easy') (p<0.0001). Patients found Tegaderm Absorbent dressings significantly more convenient to manage and bathe with. At one month post-surgery, Vancouver scar scores showed thatTegaderm Absorbent donor sites were less red, flatter, softer and less itchy.


CONCLUSIONS
Tegaderm Absorbent provides a significant improvement in terms of donor-site pain, healing and ease of management.
Department of Surgery, Monash University, Melbourne, Australia. pjterril@bigpond.net.au
P J
PJ
Terrill
R C W
RC
Goh
M J
MJ
Bailey
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000464:Alginates / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D015400:Clinical Nursing Research; D005122:Exudates and Transudates; D005260:Female; D020723:Glucuronic Acid / Q000009:adverse effects / Q000627:therapeutic use; D006603:Hexuronic Acids / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings / Q000009:adverse effects / Q000592:standards*; D010342:Patient Acceptance of Health Care; D011140:Polyurethanes; D011182:Postoperative Care / Q000295:instrumentation / Q000451:nursing; D011446:Prospective Studies; D017592:Skin Care / Q000295:instrumentation* / Q000451:nursing; D016038:Skin Transplantation / Q000009:adverse effects*; D013848:Thigh / Q000601:surgery; D014182:Transplantation, Autologous / Q000009:adverse effects; D016896:Treatment Outcome; D014739:Victoria; D014945:Wound Healing
D000464:Alginates; D006603:Hexuronic Acids; D011140:Polyurethanes; D020723:Glucuronic Acid